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infliximab and methotrexate

Kosuke Ebina, Motomu Hashimoto, Wataru Yamamoto, Akira Ohnishi, Daijiro Kabata, Toru Hirano, Ryota Hara, Masaki Katayama, Shuzo Yoshida, Koji Nagai, Yonsu Son, Hideki Amuro, Kengo Akashi, Takanori Fujimura, Makoto Hirao, Keiichi Yamamoto, Ayumi Shintani, Atsushi Kumanogoh, Hideki Yoshikawa
The purpose of this study was to evaluate the retention and discontinuation reasons of seven biological disease-modifying antirheumatic drugs (bDMARDs) in a real-world setting of patients with rheumatoid arthritis (RA). 1,037 treatment courses with bDMARDs from 2009 to 2016 [female, 81.8%; baseline age, 59.6 y; disease duration 7.8 y; rheumatoid factor positivity 81.5%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR), 4.4; concomitant prednisolone 43.5% and methotrexate 68...
2018: PloS One
John Ward, Ariela Noy, Gary Ulaner, Christopher Riedl
Adalimumab is a fully human chimeric tumor necrosis factor inhibitor used to treat immune-mediated disorders such as psoriatic arthritis. We present a 51-year-old woman with psoriatic arthritis on methotrexate and infliximab for 12 years. Adalimumab replaced infliximab because of worsening symptoms. Following 3 doses administered 1 week apart, rapidly enlarging cervical lymph nodes developed. Biopsy revealed Epstein-Barr virus-related polymorphic lymphoproliferative disorder. F-FDG PET/CT demonstrated widespread hypermetabolic lymphadenopathy; follow-up at 5 weeks off adalimumab revealed almost complete resolution of this adenopathy...
March 13, 2018: Clinical Nuclear Medicine
Patrick R Wood, Evan Manning, Joshua F Baker, Bryant England, Lisa Davis, Grant W Cannon, Ted R Mikuls, Liron Caplan
AIM: To determine the scope of acute hypoglycemic effects for certain anti-rheumatic medications in a large retrospective observational study. METHODS: Patients enrolled in the Veterans Affairs Rheumatoid Arthritis (VARA) registry were selected who, during follow-up, initiated treatment with tumor necrosis factor inhibitors (TNFi's, including etanercept, adalimumab, infliximab, golimumab, or certolizumab), prednisone, or conventional disease-modifying anti-rheumatic drugs (DMARDs), and for whom proximate random blood glucose (RBG) measurements were available within a window 2-wk prior to, and 6 mo following, medication initiation...
February 15, 2018: World Journal of Diabetes
Mio Nakamura, Michael Abrouk, Benjamin Farahnik, Tian H Zhu, Tina Bhutani
The management of psoriatic disease in the human immunodeficiency virus (HIV)-positive population is challenging. The clinical course often is progressive and refractory; therefore, first- and second-line therapies including topical agents, phototherapy, and oral retinoids often are inadequate. Most other currently available systemic therapies for psoriatic disease are immunosuppressive, which poses a distinct clinical challenge. A comprehensive systematic review of the literature via a PubMed search of articles indexed for MEDLINE using the terms psoriasis and HIV and psoriatic arthritis and HIV combined with several systemic immunosuppressive agents yielded a total of 25 reported cases of systemic immunosuppressive therapies used to treat psoriatic disease in HIV-positive patients including methotrexate, cyclosporine, etanercept, adalimumab, infliximab, and ustekinumab...
January 2018: Cutis; Cutaneous Medicine for the Practitioner
Daniela Fluxá, Jorge Segovia, Matías Florenzano, Jessica Salinas, Lilian Flores, Daniela Simian, Rodrigo Quera
There are no evidence-based guidelines about prophylaxis against Pneumocystis jiroveci pneumonia in inflammatory bowel disease. We report a case of P. jiroveci pneumonia in patient with Crohn's disease receiving infliximab and methotrexate. This case emphasizes the importance of considering the possibility of this infection in inflammatory bowel disease patients treated on biological therapy.
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Larissa F Marchi, Adriana B Paoliello-Paschoalato, Renê D R Oliveira, Ana Elisa C S Azzolini, Luciana M Kabeya, Eduardo A Donadi, Yara Maria Lucisano-Valim
We examined the functional activity of peripheral blood neutrophils and the complement system activation status in patients with rheumatoid arthritis (RA) undergoing infliximab/methotrexate combined therapy. We studied female RA patients under treatment with infliximab (3-5 mg/kg) and methotrexate (15-25 mg/week) who presented inactive (i-RA; n = 34, DAS-28 ≤ 2.6) or at least moderately active disease (a-RA; n = 29, DAS-28 > 3.2), and age-matched healthy women (n = 38). We measured the levels of reactive oxygen species (ROS) generation (chemiluminescence assay) and membrane expression of FcγRIIa/CD32, FcγRIIIb/CD16, CR1/CD35, and CR3/CD11b receptors (ELISA assay) in neutrophils...
February 20, 2018: Rheumatology International
Steven Bots, Krisztina Gecse, Murray Barclay, Geert D'Haens
Whether to use biologic treatment for inflammatory bowel disease as monotherapy or in combination with immunosuppressives has been a matter of debate in the last 2 decades. Combination therapy was not superior in any of the registration trials for Crohn's disease and ulcerative colitis for TNF antagonists, vedolizumab, or ustekinumab. It needs to be mentioned, though, that none of these trials were powered to detect such differences, and that many patients entered the trial after having failed conventional immunosuppressives...
February 15, 2018: Inflammatory Bowel Diseases
Tina D Mahajan, Ted R Mikuls
PURPOSE OF REVIEW: Therapies for rheumatoid arthritis (RA) continue to expand rapidly. The purpose of this review is to discuss novel treatment options, including biosimilars, that are available, as well as to highlight promising agents in development. The purpose is also to discuss new emerging safety signals associated with these drugs and to discuss strategies in tapering therapy. RECENT FINDINGS: There are several novel RA therapies. These include the interleukin-6 (IL-6) receptor blocker sarilumab, which was approved in 2017...
February 15, 2018: Current Opinion in Rheumatology
Sylvain Couderc, Maryse Lapeyre-Mestre, Robert Bourrel, Paul Carle, Jean-Louis Montastruc, Agnès Sommet
The aim of this study was to compare the infectious risk between a group of psoriasis patients treated by Biological Drugs (BD) and a group treated by Traditional Systemic Treatments (TST). We built a retrospective observational cohort study from the French health insurance database in the Midi-Pyrénées area (2.9 million inhabitants, South West of France) using data from 01/01/2010 to 12/31/2013. We compared the infectious risk between 'exposed' patients treated with BD (adalimumab, etanercept, infliximab or ustekinumab) and 'unexposed' patients treated by TST (phototherapy, acitretin, methotrexate or cyclosporine)...
February 15, 2018: Fundamental & Clinical Pharmacology
Joshua C Berkowitz, Joanna Stein-Fishbein, Sundas Khan, Richard Furie, Keith S Sultan
AIM: To describe trends of combination therapy (CT) of infliximab (IFX) and immunomodulator (IMM) for inflammatory bowel disease (IBD) in the community setting. METHODS: A retrospective study was conducted of all IBD patients referred for IFX infusion to our community infusion center between 04/01/01 and 12/31/14. CT was defined as use of IFX with either azathioprine, 6-mercaptopurine, or methotrexate. We analyzed trends of CT usage overall, for Crohn's disease (CD) and ulcerative colitis (UC), and for the subgroups of induction patients...
February 6, 2018: World Journal of Gastrointestinal Pharmacology and Therapeutics
Sterling G West
PURPOSE OF REVIEW: Sarcoidosis is a systemic disease characterized by noncaseating granulomatous inflammation of multiple organ systems. Pulmonary, cardiac, and neurologic involvements have the worst prognosis. Current recommendations for the therapeutic management and follow-up of sarcoidosis involving these critical organs will be reviewed. RECENT FINDINGS: In those sarcoidosis patients requiring immunosuppressive therapy, corticosteroids are used first at varying doses depending on the presenting manifestation...
January 31, 2018: Current Opinion in Rheumatology
Perry K Pratt, Nunes David, Horst C Weber, Frédéric F Little, Themistoklis Kourkoumpetis, Gregory J Patts, Janice Weinberg, Francis A Farraye
Background: Studies have demonstrated an association between anti-TNF/immunomodulator agents used in inflammatory bowel disease (IBD) and impaired hepatitis B virus (HBV) vaccine immunogenicity, but little data exist on whether specific medication types affect protective HBsAb titers. Our aim was to analyze this association. Methods: This is a retrospective cohort study. Inclusion criteria: age ≥18, diagnosis of Crohn's disease (CD) or ulcerative colitis (UC), previous HBV vaccination series and/or ≥1 positive HBsAb, and record of IBD therapy in 6 months before titer level...
January 18, 2018: Inflammatory Bowel Diseases
Taio Naniwa, Shiho Iwagaitsu, Mikiko Kajiura
AIM: To assess the long-term efficacy and safety of adding tacrolimus for patients with active rheumatoid arthritis (RA) despite anti-tumor necrosis factor (TNF) therapy with methotrexate. METHODS: Consecutive patients who were treated with adding tacrolimus onto anti-TNF therapy with methotrexate for active RA despite anti-TNF therapy with methotrexate, were retrospectively analyzed in terms of treatment response, achieving remission, subsequent treatment tapering and adverse events...
March 2018: International Journal of Rheumatic Diseases
Vítězslav Kolek, Monika Žurková, Vladimíra Lošťáková
Sarcoidosis is a systemic disease of unknown etiology, characterized by the presence of granulomatous inflammation in affected tissues. In about 90 % it affects the lungs, but it may basically affect any organ, the most frequently the skin, lymph nodes and eyes. In the case of classic lung manifestation this disease is not difficult to diagnose. When dealing with extrapulmonary manifestations, interdisciplinary cooperation is necessary. The treatment of sarcoidosis is needed in about half of the cases, in some 30 % of patients it may change into a chronic stage and possibly lead to serious health problems or premature death...
2018: Vnitr̆ní Lékar̆ství
Masuho Saburi, Masao Ogata, Natsumi Yoshida, Yuko Nashimoto, Yui Moroga, Kuniko Takano, Kazuhiro Kohno, Tsutomu Daa, Kuniaki Shirao
A 59-year-old man with an 18-year history of rheumatoid arthritis who had been treated with steroids, methotrexate, and infliximab presented with a high-grade fever, cervical lymphadenopathy, and hepatosplenomegaly. Epstein-Barr virus (EBV) hepatitis was diagnosed based on the liver histology and EBV antibody titer. The symptoms improved temporarily, but five months later, the fever, skin rash, jaundice, and thrombocytopenia relapsed. Bone marrow and liver biopsies demonstrated infiltration with Reed-Sternberg cells...
December 27, 2017: Internal Medicine
Graeme Jones, Stephen Hall, Paul Bird, Geoff Littlejohn, Kathleen Tymms, Peter Youssef, Eric Chung, Rina Barrett, Peter Button
AIM: To describe the persistence of biologic disease modifying anti-rheumatic drugs (bDMARDs) in Australian rheumatoid arthritis (RA) patients, and assess the influence of methotrexate and other conventional DMARD (cDMARD) concomitant medications, and treatment line on bDMARD persistence and glucocorticoids usage. METHOD: RA patients, from the 10% Australian Medicare random sample, aged ≥18 for whom bDMARDs were dispensed were included. Individual sub-cutaneous (SC) anti-tumor necrosis factor-α (anti-TNFα) agents were combined as they were equivalent...
December 5, 2017: International Journal of Rheumatic Diseases
Maria A Lopez-Olivo, Voke Kakpovbia-Eshareturi, Jude des Bordes, Andrea Barbo, Robin Christensen, Maria E Suarez-Almazor
OBJECTIVE: We undertook a systematic review and meta-analysis of direct and indirect trial evidence to evaluate the efficacy of treatments for patients with undifferentiated arthritis (UA). METHODS: We searched four electronic databases from inception to January 2016, clinicaltrials. gov, and bibliographies of relevant articles. Two reviewers independently screened and evaluated the studies. The primary outcome was development of rheumatoid arthritis (RA). RESULTS: Nine studies were included...
November 21, 2017: Arthritis Care & Research
Paolo Gisondi, Micol Del Giglio, Giampiero Girolomoni
Psoriasis is a common disease, which has a considerable impact on patients and the health care system. Treatment approaches to the disease may be various because some issues are not definitely addressed. Moreover, the therapeutic paradigms are continuously changing because of the recent approval of new treatments for psoriasis such as interleukin (IL)-17 inhibitors and apremilast. In this review, the factors influencing psoriasis severity, the indications for systemic treatments, the overall parameters to be considered in the treatment choice, life style interventions, and the recommendations for the use, screening, and monitoring of systemic therapies available including acitretin, cyclosporine, methotrexate, apremilast, adalimumab, etanercept, infliximab, secukinumab, ixekizumab, and ustekinumab are discussed...
November 16, 2017: International Journal of Molecular Sciences
Toshihiro Ito, Hidetoshi Takahashi, Akira Kawada, Hajime Iizuka, Hidemi Nakagawa
Since 1982, the Japanese Society for Psoriasis Research has conducted annual epidemiological surveys of patients with psoriasis. Kawada et al. have reported data for 1982-2001 and Takahashi et al. have reported data for 2002-2008. The present study evaluated 9290 psoriatic cases according to age and sex (2009-2012). The male : female ratio was 2.08:1 (6281 male patients [67.6%] to 3009 female patients [32.4%]). The most prevalent type was psoriasis vulgaris (85.6% of all cases), which was followed by psoriasis arthropathica (6...
November 8, 2017: Journal of Dermatology
Bastien Joubert, Catherine Chapelon-Abric, Lucie Biard, David Saadoun, Sophie Demeret, Didier Dormont, Matthieu Resche-Rigon, Patrice Cacoub
Importance: Prognostic factors are lacking in neurosarcoidosis (NS), and the association of immunosuppressive treatments with outcomes are unclear. Objectives: To identify prognostic factors of and analyze the association of immunosuppressive treatment with relapse of NS. Design, Setting, and Participants: In this retrospective study, a cohort of 234 patients fulfilled the diagnostic criteria for NS in a tertiary referral center in Paris, France, from January 1, 1990, through December 31, 2015...
November 1, 2017: JAMA Neurology
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