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https://www.readbyqxmd.com/read/28282491/biologics-or-tofacitinib-for-people-with-rheumatoid-arthritis-unsuccessfully-treated-with-biologics-a-systematic-review-and-network-meta-analysis
#1
REVIEW
Jasvinder A Singh, Alomgir Hossain, Elizabeth Tanjong Ghogomu, Amy S Mudano, Lara J Maxwell, Rachelle Buchbinder, Maria Angeles Lopez-Olivo, Maria E Suarez-Almazor, Peter Tugwell, George A Wells
BACKGROUND: Biologic disease-modifying anti-rheumatic drugs (DMARDs: referred to as biologics) are effective in treating rheumatoid arthritis (RA), however there are few head-to-head comparison studies. Our systematic review, standard meta-analysis and network meta-analysis (NMA) updates the 2009 Cochrane overview, 'Biologics for rheumatoid arthritis (RA)' and adds new data. This review is focused on biologic or tofacitinib therapy in people with RA who had previously been treated unsuccessfully with biologics...
March 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28264816/eular-recommendations-for-the-management-of-rheumatoid-arthritis-with-synthetic-and-biological-disease-modifying-antirheumatic-drugs-2016-update
#2
Josef S Smolen, Robert Landewé, Johannes Bijlsma, Gerd Burmester, Katerina Chatzidionysiou, Maxime Dougados, Jackie Nam, Sofia Ramiro, Marieke Voshaar, Ronald van Vollenhoven, Daniel Aletaha, Martin Aringer, Maarten Boers, Chris D Buckley, Frank Buttgereit, Vivian Bykerk, Mario Cardiel, Bernard Combe, Maurizio Cutolo, Yvonne van Eijk-Hustings, Paul Emery, Axel Finckh, Cem Gabay, Juan Gomez-Reino, Laure Gossec, Jacques-Eric Gottenberg, Johanna M W Hazes, Tom Huizinga, Meghna Jani, Dmitry Karateev, Marios Kouloumas, Tore Kvien, Zhanguo Li, Xavier Mariette, Iain McInnes, Eduardo Mysler, Peter Nash, Karel Pavelka, Gyula Poór, Christophe Richez, Piet van Riel, Andrea Rubbert-Roth, Kenneth Saag, Jose da Silva, Tanja Stamm, Tsutomu Takeuchi, René Westhovens, Maarten de Wit, Désirée van der Heijde
Recent insights in rheumatoid arthritis (RA) necessitated updating the European League Against Rheumatism (EULAR) RA management recommendations. A large international Task Force based decisions on evidence from 3 systematic literature reviews, developing 4 overarching principles and 12 recommendations (vs 3 and 14, respectively, in 2013). The recommendations address conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs) (methotrexate (MTX), leflunomide, sulfasalazine); glucocorticoids (GC); biological (b) DMARDs (tumour necrosis factor (TNF)-inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab), abatacept, rituximab, tocilizumab, clazakizumab, sarilumab and sirukumab and biosimilar (bs) DMARDs) and targeted synthetic (ts) DMARDs (Janus kinase (Jak) inhibitors tofacitinib, baricitinib)...
March 6, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28260120/long-term-outcomes-of-refractory-neurosarcoidosis-treated-with-infliximab
#3
Fleur Cohen Aubart, Diane Bouvry, Damien Galanaud, Caroline Dehais, Guillaume Mathey, Dimitri Psimaras, Julien Haroche, Corinne Pottier, Miguel Hie, Alexis Mathian, Hervé Devilliers, Hilario Nunes, Dominique Valeyre, Zahir Amoura
Central nervous system localizations of sarcoidosis may be refractory to conventional treatment such as steroids and immunosuppressive drugs. Infliximab, a TNF-α antagonist chimeric antibody, has been shown to be effective for treatment of these localizations. The aim of this study was to evaluate the efficacy and safety, in particular the long-term outcomes, of the use of infliximab for the treatment of neurosarcoidosis. We retrospectively reviewed medical records of patients with neurosarcoidosis who had been treated with infliximab between 2009 and 2015...
March 4, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28230306/suppression-of-anti-drug-antibodies-to-infliximab-or-adalimumab-with-the-addition-of-an-immunomodulator-in-patients-with-inflammatory-bowel-disease
#4
A S Strik, G R van den Brink, C Ponsioen, R Mathot, M Löwenberg, G R D'Haens
BACKGROUND: Loss of response to anti-tumour necrosis factor (TNF) therapy in patients with inflammatory bowel disease (IBD) is often caused by anti-drug antibody formation with neutralisation of drug effect. Addition of an immunomodulator has been suggested to reduce immunogenicity, leading to regained response. AIM: To investigate whether addition of an immunomodulator to anti-TNF monotherapy could lead to anti-drug antibody suppression and regained clinical response in IBD patients...
February 23, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28194815/peristomal-psoriasis
#5
C Marshall, S Woodmansey, C C Lyon
BACKGROUND: Psoriasis is a common skin condition, affecting 1.3-2.2% of the population. The prevalence of psoriasis has previously been reported as 11.2% in patients with Crohn disease (CD) and 5.7% in patients with ulcerative colitis. AIM: To assess the prevalence of psoriasis around stoma sites and identify the most effective treatment. METHODS: A departmental database of all patients attendings stoma clinic was accessed between 1 May 2003 and 15 October 2015...
February 13, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28166613/melanocytic-nevus-count-and-dermoscopic-features-do-not-differ-in-psoriatic-patients-undergoing-biological-agent-versus-conventional-drug-therapy
#6
Serpil Pirmit, Nahide Onsun, Ozlem Su, Dilek B Ozkaya
BACKGROUND: Psoriasis is a chronic immune-mediated disease and treatment of psoriasis includes conventional immunosuppressive agents and biological agents. There are a few data on the relationship between psoriasis and melanocytic lesions. Either benign or malignant proliferations may be seen with immunosuppressive treatment. Eruptive nevi and malignant melanoma (MM) have been reported also associated with biological agents There is raising link biological treatment and malignancies. The objective of this paper is to examine the effects of biological agents versus conventional drugs on melanocytic nevi count and dermoscopical features...
April 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28160250/thiopurines-and-methotrexate-use-in-ibd-patients-in-a-biologic-era
#7
REVIEW
Gerassimos J Mantzaris
Although we have been living in the era of biologic therapy for several decades, the use of immunomodulators (primarily thiopurines [azathioprine and mercaptopurine] and less so methotrexate) still remains an important component of the inflammatory bowel disease (IBD) pharmaceutical arsenal. Thiopurines as monotherapy exert corticosteroid-sparing effects and can maintain long-term remission in a considerable proportion of patients who have frequent relapses and are or have become mesalazine and/or corticosteroid intolerant or refractory...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28147380/promises-and-dangers-of-combination-therapy
#8
REVIEW
Wolfgang Kruis, Phuong G Nguyen, Julia Morgenstern
The efficiency of the existing methods of treating inflammatory bowel disease (IBD) is limited. There are 2 ways to address this problem - either create new treatment modalities or optimize current therapies. Optimisation may be accomplished by using combinations of established therapeutic strategies. With regard to topically acting compounds such as 5-aminosalicylic acid, combining oral and rectal preparations is a commonly used method. Another commonly used combination is anti-tumor necrosis factor (TNF)-α antibody modalities together with immunosuppressants (thiopurines, methotrexate)...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28144615/isolated-ileal-stricture-secondary-to-antigen-negative-gi-histoplasmosis-in-a-patient-on-immunosuppressive-therapy
#9
Kyle M Rowe, Michael Green, Fredy Nehme, Nathan Tofteland
We present a case of antigen-negative disseminated histoplasmosis manifesting as an isolated ileal stricture in a patient on chronic infliximab and methotrexate. Diagnosis can be challenging due to imperfect tests, and this condition should remain in the differential, even with negative testing. Mortality of untreated disseminated histoplasmosis can be as high as 80%.
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28134599/new-onset-or-worsening-of-psoriasis-following-biologic-therapy-a-case-series
#10
Vincenzo Bruzzese, Vincenzo De Francesco, Cesare Hassan, Roberto Lorenzetti, Palma Scolieri, Cinzia Marrese, Angelo Zullo
Biologic therapies may cause so-called "paradoxical side-effects," that is, the onset or exacerbation of new symptoms/diseases for which biological treatment should be effective. Among these, psoriatic skin lesions have been described. We report a case series of ten patients with either new onset (seven cases) or worsening (three cases) of psoriasis occurring during a biologic therapy. Six patients were receiving a biologic monotherapy, while four patients were in combination treatment with methotrexate (MTX)...
January 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/28125553/o-005-combination-therapy-with-methotrexate-does-not-change-infliximab-pharmacokinetics-in-children-with-inflammatory-bowel-disease
#11
Valentina Shakhnovich, Leon Van Haandel, Mara Becker, Ryan Funk
BACKGROUND: There remains a question of equipoise regarding the use of anti-TNF-α agent (e.g., infliximab) monotherapy versus combination therapy with immunomodulators (e.g., methotrexate), for the treatment of pediatric Inflammatory Bowel Disease (IBD). The aim of this prospective cross-sectional study was to assess the impact of methotrexate (MTX) on infliximab (IFX) pharmacokinetics (i.e., serum trough levels) and infliximab antibody (anti-IFX) formation in children with IBD. METHODS: Forty-one children with IBD (9-21 yr of age), receiving maintenance IFX infusions as part of their standard-of-medical-care, had serum IFX and anti-IFX concentrations assessed via an established NF-kB luciferase gene-reporter assay (ARUP Laboratories)...
February 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28038888/biologic-drug-survival-in-israeli-psoriasis-patients
#12
Guy Shalom, Arnon D Cohen, Michael Ziv, Cohen Barak Eran, Ilan Feldhamer, Tamar Freud, Eitan Berman, Shirley Oren, Emmilia Hodak, Lev Pavlovsky
BACKGROUND: Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown. OBJECTIVE: To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors. METHODS: Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database...
December 28, 2016: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/27992691/a-multi-biomarker-disease-activity-score-and-the-choice-of-second-line-therapy-in-early-rheumatoid-arthritis-after-methotrexate-failure
#13
Karen Hambardzumyan, Saedis Saevarsdottir, Kristina Forslind, Ingemar F Petersson, Johan K Wallman, Sofia Ernestam, Rebecca J Bolce, Ronald F van Vollenhoven
OBJECTIVE: We investigated whether the multi-biomarker disease activity (MBDA) score predicts optimal add-on treatment in methotrexate-inadequate-responders (MTX-IR) in early rheumatoid arthritis (RA). METHODS: We analysed 157 MTX-IRs (28-joint disease activity score based on erythrocyte sedimentation rate [DAS28-ESR] >3.2) from the Swedish Farmacotherapy (SWEFOT) trial who were randomized to triple therapy (TT [MTX+sulfasalazine+hydroxychloroquine]) versus MTX+infliximab...
December 19, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27990383/biologics-use-in-indian-psoriasis-patients
#14
Murlidhar Rajagopalan, Asit Mital
The biologics currently in use for psoriasis in India are etanercept, infliximab and recently introduced itolizumab and secukinumab. Biosimilars, expected to play a significant role in psoriasis management in future, have also been available for the last few years. Patients with psoriasis may be considered eligible to receive treatment with any of the licensed biologic interventions when they fulfill the eligibility criteria. The decision to proceed with treatment must be made in collaboration with the patient and include a careful assessment of the associated risks and benefits...
November 2016: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/27959350/progressive-multifocal-leukoencephalopathy-associated-with-infliximab
#15
L Sammut, D Wallis, C Holroyd
A 69-year-old female with seropositive rheumatoid arthritis presented with progressive cognitive decline following treatment with infliximab and methotrexate. Cranial MRI showed non-enhancing white matter signal abnormality consistent with demyelination was seen in the antero-inferior left frontal lobe extending into the frontal opercular white matter and into the left temporal lobe white matter. Similar appearances were seen in the inferomedial right frontal lobe. Brain biopsy showed histological changes consistent with progressive multifocal leukoencephalopathy...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27931515/autologous-adipose-derived-mesenchymal-stromal-cells-for-the-treatment-of-psoriasis-vulgaris-and-psoriatic-arthritis-a-case-report
#16
Miguel M De Jesus, Jayson S Santiago, Camille V Trinidad, Melvin E See, Kimberly R Semon, Manuel O Fernandez, Francisco S Chung
Psoriasis is a dermatologic disease of immune origins with no definitive cure. We report the Makati Medical Center experience of utilizing autologous mesenchymal stromal cells (MSCs) for one patient with psoriasis vulgaris (PV) and another with psoriatic arthritis (PA). Patients were educated and gave informed consent, according to the principles of the Declaration of Helsinki. The protocol was approved by the Cellular Transplantation Ethics Committee of the Makati Medical Center. Autologous MSCs were cultured from lipoaspirate and expanded in a clean room class 100 facility (Cellular Therapeutics Center, Makati Medical Center)...
November 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27931158/drug-survival-on-tumour-necrosis-factor-inhibitors-in-patients-with-rheumatoid-arthritis-in-finland
#17
K J Aaltonen, J T Joensuu, L Pirilä, M Kauppi, T Uutela, T Varjolahti-Lehtinen, T Yli-Kerttula, P Isomäki, D Nordström, T Sokka
OBJECTIVE: A systematic review found that an average of 27% of rheumatoid arthritis (RA) patients using tumour necrosis factor (TNF) inhibitors discontinue their treatment within 1 year. The aim of this study was to assess drug survival on TNF inhibitors among patients with RA. METHODS: Patients were identified from the National Register for Biologic Treatment in Finland (ROB-FIN), which is a longitudinal cohort study established to monitor the effectiveness and safety of biologic drugs in rheumatic diseases...
December 8, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27927829/lesson-of-the-month-1-lobar-pulmonary-consolidation-in-an-immunocompromised-host
#18
Daniel J Reynolds, Carl A Andersen, Sumedh S Hoskote, Hee Eun Lee, Aditya Raghunathan, Sanjay Kalra, Andrew H Limper
A 19-year-old male with a history of idiopathic panuveitis, currently taking methotrexate and infliximab, presented to our institution with 6 weeks of cough, dyspnoea and fevers. He had failed outpatient antimicrobial therapy. Computerised tomography (CT) of the chest revealed the presence of a lobar pneumonia and he was treated with broad spectrum antibiotics, which did not improve his symptoms. Bronchoalveolar lavage was performed with a transbronchial lung biopsy because of the diagnostic uncertainty of the patient's presentation...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27881258/cost-effectiveness-analysis-of-tocilizumab-in-comparison-with-infliximab-in-iranian-rheumatoid-arthritis-patients-with-inadequate-response-to-tdmards-a-multistage-markov-model
#19
Amir Hashemi-Meshkini, Shekoufeh Nikfar, Elizabeth Glaser, Ahmadreza Jamshidi, Seyed Alireza Hosseini
OBJECTIVES: To analyze the cost-effectiveness of two common treatment strategies in Iran, comparing infliximab plus methotrexate with tocilizumab plus methotrexate in patients with rheumatoid arthritis with inadequate response to traditional disease-modifying antirheumatic drugs. METHODS: A multistage Markov decision model was applied to assess the incremental cost-effectiveness ratio (ICER) of a tocilizumab-containing regimen versus an infliximab-containing regimen over a 5-year time period...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27879076/drug-survival-rates-and-reasons-for-drug-discontinuation-in-psoriasis
#20
Tobias Arnold, Marthe-Lisa Schaarschmidt, Raphael Herr, Joachim E Fischer, Sergij Goerdt, Wiebke K Peitsch
BACKGROUND AND OBJECTIVES: Moderate-to-severe psoriasis frequently requires long-term systemic therapy. Reflecting efficacy, safety, and treatment satisfaction, drug survival is an indicator of therapeutic success. The objective of the present study was to assess drug survival rates and reasons for discontinuation of fumaric acid esters (FAE), methotrexate (MTX), acitretin (ACI), cyclosporine A (CyA), adalimumab (ADA), etanercept (ETA), infliximab (INF), and ustekinumab (UST) in patients with moderate-to-severe psoriasis...
November 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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