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infliximab and methotrexate

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
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
Rafael Alfonso-Cristancho, Nigel Armstrong, Ramesh Arjunji, Rob Riemsma, Gill Worthy, Rita Ganguly, Jos Kleijnen
Our aim was to establish the comparative effectiveness of rheumatoid arthritis (RA) biologics, using a systematic review and network meta-analysis. The systematic review used randomized controlled trials (RCTs) in adults with RA who failed treatment with conventional disease-modifying agents for rheumatoid disease (cDMARDs). We compared the effectiveness of abatacept, adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, and rituximab to tocilizumab, a recent biologic with a different mechanism of action (anti-IL-6 receptor)...
October 10, 2016: Clinical Rheumatology
Vivian Wai-Mei Huang, Hsiu-Ju Chang, Karen Ivy Kroeker, Karen Jean Goodman, Kathleen M Hegadoren, Levinus Albert Dieleman, Richard Neil Fedorak
Background. Inflammatory bowel disease (IBD) affects patients in their young reproductive years. Women with IBD require maintenance therapies during pregnancy and breastfeeding. However, physician management of IBD during pregnancy and breastfeeding has not been well characterized. Objective. To characterize physician perceptions and management of IBD during pregnancy and breastfeeding. Methods. A cross-sectional survey of Canadian physicians who are involved in the care of women with IBD was conducted. The survey included multiple-choice and Likert scale questions about perceptions and practice patterns regarding the management of IBD during pregnancy and breastfeeding...
2016: Canadian Journal of Gastroenterology & Hepatology
Ennio Giulio Favalli, Carlo Selmi, Andrea Becciolini, Martina Biggioggero, Alarico Ariani, Daniele Santilli, Enrico Fusaro, Simone Parisi, Marco Massarotti, Antonio Marchesoni, Pier Luigi Meroni
OBJECTIVE: To evaluate the 8-year survival of the first TNF inhibitor (TNFi) in patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA), identify the predictive factors for withdrawal, and compare the discontinuation rates for infliximab, etanercept, and adalimumab. METHODS: We evaluated PsA and axSpA patients treated with a first-line TNFi between 2005 and 2015 at four Italian tertiary centres. 8-year drug survival was calculated by Kaplan-Meier method and risk for discontinuation among treatment groups compared by stratified log-rank test...
October 1, 2016: Arthritis Care & Research
Michael E Mack, Elizabeth Hsia, Daniel Aletaha
OBJECTIVE: The American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) have defined remission using Boolean- or index-based criteria (i.e., the Simplified Disease Activity Index [SDAI] ≤3.3). The Clinical Disease Activity Index (CDAI) ≤2.8) also was included in our comparison of remission definitions to inform endpoint choice for future rheumatoid arthritis (RA) clinical trials. METHODS: We performed post-hoc analyses on clinical remission rates using data from infliximab (ASPIRE/ATTRACT) and golimumab (GO-FORWARD) trials...
October 1, 2016: Arthritis & Rheumatology
Paula Dávila-Seijo, Esteban Dauden, M A Descalzo, Gregorio Carretero, José-Manuel Carrascosa, Francisco Vanaclocha, Francisco-José Gómez-García, Pablo De la Cueva-Dobao, Enrique Herrera-Ceballos, Isabel Belinchón, José-Luis López-Estebaranz, Merce Alsina, José-Luis Sánchez-Carazo, Marta Ferrán, Rosa Torrado, Carlos Ferrandiz, Raquel Rivera, Mar Llamas, Rafael Jiménez-Puya, Ignacio García-Doval
Information regarding the safety of biological drugs prescribed to psoriasis patients on daily and long-term bases is insufficient. We used data from the BIOBADADERM registry (Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases) to generate crude rates of infection during therapy with systemic drugs, including biological drugs (infliximab, etanercept, adalimumab, and ustekinumab) and non-biological drugs (acitretin, cyclosporine, and methotrexate). We also calculated unadjusted and adjusted risk ratios (RR) (with propensity score adjustment) of infection, serious infections, and recurrent infections of systemic therapies compared with methotrexate, using Poisson regression...
September 24, 2016: Journal of Investigative Dermatology
Sharzad Emamikia, Elizabeth V Arkema, Noémi Györi, Jacqueline Detert, Katerina Chatzidionysiou, Maxime Dougados, Gerd Rüdiger Burmester, Ronald van Vollenhoven
OBJECTIVE: To determine whether an induction-maintenance strategy of combined therapy (methotrexate (MTX)+tumour necrosis factor (TNF) inhibitor (TNFi)) followed by withdrawal of TNFi could yield better long-term results than a strategy with MTX monotherapy, since it is unclear if the benefits from an induction phase with combined therapy are sustained if TNFi is withdrawn. METHODS: We performed a meta-analysis of trials using the initial combination of MTX+TNFi in conventional synthetic disease-modifying antirheumatic drug-naïve patients with early rheumatoid arthritis (RA)...
2016: RMD Open
Lesley-Anne Bissell, Elizabeth M A Hensor, Lukasz Kozera, Sarah L Mackie, Agata N Burska, Jacqueline L Nam, Helen Keen, Edith Villeneuve, Helena Donica, Maya H Buch, Philip G Conaghan, Jacqueline Andrews, Paul Emery, Ann W Morgan
OBJECTIVES: To determine the change in established biomarkers of cardiovascular (CV) risk, namely, total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDL-C), N-terminal pro-brain natriuretic peptide (NT-proBNP) and insulin resistance (IR) in patients with early RA treated with two different treat-to-target strategies. METHODS: Fasting glucose, lipids, insulin and NT-proBNP were measured at baseline, weeks 26 and 78 in 79 DMARD-naïve RA patients, free of CV disease, as part of a double-blind randomized controlled trial of MTX with either infliximab (IFX) or methylprednisolone as induction therapy...
September 16, 2016: Rheumatology
Yusuke Miwa, Sakiko Isojima, Mayu Saito, Yuzo Ikari, Mika Kobuna, Tomoki Hayashi, Ryo Takahashi, Tsuyoshi Kasama, Michio Hosaka, Kenji Sanada
Objective We examined whether infliximab (IFX) therapy was more effective than methotrexate (MTX) monotherapy to achieve an improvement in depressive states in Rheumatoid Arthritis (RA) patients. Methods We examined 152 RA patients (72 IFX patients and 80 MTX patients). We conducted an open-label cohort study to evaluate the disease activity of RA (Simplified Disease Activity Index; SDAI), depressive states (Hamilton Rating Scale for Depression; HAM-D), Activity of Daily Living (ADL) (modified Health Assessment Questionnaire; mHAQ) and Quality of Life (QOL) [Short Form (SF)-36] in patients before and 6 months after receiving therapy...
2016: Internal Medicine
Adrian Levitsky, Marius C Wick, Timo Möttönen, Marjatta Leirisalo-Repo, Leena Laasonen, Markku Korpela, Ronald F van Vollenhoven, Vappu Rantalaiho
OBJECTIVES: Predicted versus observed radiographic progression in early rheumatoid arthritis (POPeRA) was applied to demonstrate how various treatment modalities affect and potentially minimise radiographic progression over time. METHODS: The POPeRA method utilises the baseline radiographic score and patient-reported symptom duration to predict radiographic outcomes. It was applied at baseline, 2, and 5 years to patients with eRA from the randomised Finnish RA Combination trial (FIN-RACo) (n=144) and New Finnish RA Combination Therapy (NEO-RACo) (n=90) trials...
August 31, 2016: Clinical and Experimental Rheumatology
Martin Soubrier, Bruno Pereira, Thomas Frayssac, Dihya Abdi, Marion Couderc, Coline Daron, Sandrine Malochet-Guinamand, Sylvain Mathieu, Zuzana Tatar, Anne Tournadre, Jean-Jacques Dubost
OBJECTIVES: While several registries have already evaluated the retention of anti-TNF therapy in psoriatic arthritis (PsA), they sometimes reach divergent conclusions. Our study therefore sought to assess therapeutic retention rates and predictive factors of response in a patient cohort from Auvergne, France, followed up in routine clinical practice. METHODS: Medical records of all PsA patients treated from 2002 to May 2015 were analysed. PsA diagnosis was established based on the CASPAR criteria...
August 31, 2016: Clinical and Experimental Rheumatology
V Bruzzese, P Scolieri, C Hassan, R Lorenzetti, A Zullo
Spondylodiscitis (Andersson lesion) is an infrequent and late complication of advanced ankilosing arthritis. Scanty data on the efficacy of anti-TNF therapy for these lesions are available. To our knowledge, only few cases of spondylodiscitis occurring in patients with psoriatic arthritis were reported in literature. We describe the case of a patient with psoriatic arthritis who early developed Andersson lesions successfully treated with infliximab plus methotrexate therapy.
April 2016: Acta Reumatológica Portuguesa
Christophe Passot, Denis Mulleman, Theodora Bejan-Angoulvant, Alexandre Aubourg, Stephanie Willot, Thierry Lecomte, Laurence Picon, Philippe Goupille, Gilles Paintaud, David Ternant
Infliximab is an anti-tumor necrosis factor monoclonal antibody approved in chronic inflammatory diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), Crohn's disease (CD) and ulcerative colitis (UC). Infliximab pharmacokinetics is variable between patients, but influence of the underlying disease was never assessed. This study aimed at assessing this influence using a cohort of patients monitored in a single center and with the same assay. Infliximab trough concentrations were determined on samples collected between weeks 0 and 22 after treatment initiation in 218 patients treated for RA, PsA, AS, CD or UC...
August 9, 2016: MAbs
Christina Ekenberg, Nina Friis-Møller, Thomas Ulstrup, Claus Aalykke
We present a case of a 56-year-old woman with Crohn's disease, treated with methotrexate and infliximab, who inadvertently received yellow fever vaccination (YFV) prior to a journey to Tanzania. She was not previously vaccinated against YF. YFV contains live-attenuated virus, and is contraindicated in patients treated with immunosuppressive drugs. Following vaccination, the patient fell ill with influenza-like illness. Elevated transaminase levels and YF viremia were detected. Despite being immunocompromised, the patient did not develop more severe adverse effects...
2016: BMJ Case Reports
Glen S Hazlewood, Cheryl Barnabe, George Tomlinson, Deborah Marshall, Daniel J A Devoe, Claire Bombardier
BACKGROUND: Methotrexate is considered the preferred disease-modifying anti-rheumatic drug (DMARD) for the treatment of rheumatoid arthritis, but controversy exists on the additional benefits and harms of combining methotrexate with other DMARDs. OBJECTIVES: To compare methotrexate and methotrexate-based DMARD combinations for rheumatoid arthritis in patients naïve to or with an inadequate response (IR) to methotrexate. METHODS: We systematically identified all randomised controlled trials with methotrexate monotherapy or in combination with any currently used conventional synthetic DMARD , biologic DMARDs, or tofacitinib...
2016: Cochrane Database of Systematic Reviews
Shin-Ichiro Hagiwara, Mitsuru Kubota, Ryusuke Nambu, Seiichi Kagimoto
No abstract text is available yet for this article.
February 15, 2016: Journal of Pediatric Gastroenterology and Nutrition
Nicholas Jones
PURPOSE: To highlight the rare but life-threatening infective consequences of immunosuppression or biologic treatment for sight-threatening uveitis. PATIENTS AND METHODS: Retrospective case series of four immunosuppressed patients with uveitis complicated by sepsis. RESULTS: The affected patients were all treated using prednisolone 10 mg/day or greater, together with oral immunosuppression (2 mycophenolate mofetil, 1 azathioprine + ciclosporin, 1 methotrexate) and, in one case, infliximab...
August 19, 2016: Ocular Immunology and Inflammation
Liang Zhao, Kaiyu Zhou, Yimin Hua, Yifei Li, Dezhi Mu
INTRODUCTION: Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative disorder of the synovial membrane that typically presents in adults and affects a single joint. Multifocal PVNS is very rare, particularly in childhood. We reported a rare case of multifocal PVNS affecting over 20 joints in a child. CLINICAL PROCEDURE: A 7-year-old female patient had a 6-month history of multifocal joints swelling with mild pain. She was diagnosed as polyarticular juvenile idiopathic arthritis at a local hospital...
August 2016: Medicine (Baltimore)
Laura A Kuusalo, Kari T Puolakka, Hannu Kautiainen, Eeva M Alasaarela, Pekka J Hannonen, Heikki A Julkunen, Oili A Kaipiainen-Seppänen, Markku M Korpela, Timo T Möttönen, Leena H Paimela, Ritva L Peltomaa, Timo K Yli-Kerttula, Marjatta Leirisalo-Repo, Vappu M Rantalaiho
OBJECTIVES: To study the effects of neglecting intra-articular glucocorticoid injections (IAGCIs) into swollen joints in early rheumatoid arthritis (RA). METHODS: Ninety-nine patients with early, DMARD naive RA were treated, aiming at remission, with methotrexate, sulfasalazine, hydroxychloroquine, low-dose oral prednisolone and, when needed, IAGCIs for 2 years, and randomised to receive infliximab or placebo from weeks 4 to 26. During each of the 15 study visits, patients were scored retrospectively 0...
August 2, 2016: Clinical and Experimental Rheumatology
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