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https://www.readbyqxmd.com/read/28454112/the-challenge-of-treating-hepatitis-c-virus-associated-cryoglobulinemic-vasculitis-in-the-era-of-anti-cd20-monoclonal-antibodies-and-direct-antiviral-agents
#1
REVIEW
Dario Roccatello, Savino Sciascia, Daniela Rossi, Laura Solfietti, Roberta Fenoglio, Elisa Menegatti, Simone Baldovino
Mixed cryoglobulinemia syndrome (MC) is a systemic vasculitis involving kidneys, joints, skin, and peripheral nerves. While many autoimmune, lymphoproliferative, and neoplastic disorders have been associated with this disorder, hepatitis C virus (HCV) is known to be the etiologic agent in the majority of patients. Therefore, clinical research has focused on anti-viral drugs and, more recently, on the new, highly potent Direct-acting Antiviral Agents (DAAs). These drugs assure sustained virologic response (SVR) rates >90%...
April 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28453594/-shock-as-an-adverse-reaction-to-rituximab-case-report
#2
Estefanía Palma, Vicente González, Daniela Grünholz, María Landaeta, María Mallea, José Pérez, Tomás Armstrong
Rituximab is a plausible alternative first-line treatment of ANCA-associated vasculitis. Adverse effects related to its infusion are common and usually have a benign course. However, there have been reports of refractory cardiogenic shock simulating septic shock. We report an 81-year-old male with the diagnosis of ANCA associated vasculitis. Rituximab 500 mg was administered intravenously for a relapse. The infusion proceeded without incident. However, 24 hours after its administration the patient began with fever, chills, coughing and strong malaise...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28440561/anterior-st-elevation-myocardial-infarction-induced-by-rituximab-infusion-a-case-report-and-review-of-the-literature
#3
K Sharif, A Watad, N L Bragazzi, E Asher, A Abu Much, Y Horowitz, M Lidar, Y Shoenfeld, H Amital
WHAT IS KNOWN AND OBJECTIVES: Rituximab is a chimeric monoclonal anti-CD20 antibody approved for the treatment of some lymphoid malignancies as well as for autoimmune diseases including rheumatoid arthritis (RA), idiopathic thrombocytopenic purpura (ITP) and vasculitis. Generally, rituximab is well tolerated; nevertheless, some patients develop adverse effects including infusion reactions. Albeit rare, these reactions may in some cases be life-threatening conditions. Rituximab cardiovascular side effects include more common effects such as hypertension, oedema and rare cases of arrhythmias and myocardial infarction...
June 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28414152/rituximab-for-immunologic-renal-disease-what-the-nephrologist-needs-to-know
#4
REVIEW
Andreas Kronbichler, Martin Windpessl, Herwig Pieringer, David R W Jayne
Rituximab (RTX), a chimeric, monoclonal anti-CD20 antibody, is increasingly used in immune-mediated renal diseases. While licensed in the induction treatment of ANCA-associated vasculitis, it represents one of the most commonly prescribed off-label drugs. Much of the information regarding its safety has been drawn from experience in hematology and rheumatology. Ample evidence illustrates the safety of RTX, however, rare but serious adverse events have emerged that include progressive multifocal leucoencephalopathy and hepatitis B reactivation...
April 13, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28400446/randomized-trial-of-c5a-receptor-inhibitor-avacopan-in-anca-associated-vasculitis
#5
David R W Jayne, Annette N Bruchfeld, Lorraine Harper, Matthias Schaier, Michael C Venning, Patrick Hamilton, Volker Burst, Franziska Grundmann, Michel Jadoul, István Szombati, Vladimír Tesař, Mårten Segelmark, Antonia Potarca, Thomas J Schall, Pirow Bekker
Alternative C activation is involved in the pathogenesis of ANCA-associated vasculitis. However, glucocorticoids used as treatment contribute to the morbidity and mortality of vasculitis. We determined whether avacopan (CCX168), an orally administered, selective C5a receptor inhibitor, could replace oral glucocorticoids without compromising efficacy. In this randomized, placebo-controlled trial, adults with newly diagnosed or relapsing vasculitis received placebo plus prednisone starting at 60 mg daily (control group), avacopan (30 mg, twice daily) plus reduced-dose prednisone (20 mg daily), or avacopan (30 mg, twice daily) without prednisone...
April 11, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28397125/diffuse-alveolar-hemorrhage-in-autoimmune-diseases
#6
REVIEW
Marco Ulises Martínez-Martínez, David Alejandro Herrera-van Oostdam, Carlos Abud-Mendoza
PURPOSE OF REVIEW: The present paper establishes a narrative and analytical review of diffuse alveolar hemorrhage (DAH) in ANCA-associated vasculitis, systemic lupus erythematosus, and antiphospholipid syndrome. RECENT FINDINGS: Recent studies found a frequent association between DAH and infections and systemic lupus erythematosus and its associated factors. Biological therapies like rituximab have demonstrated benefit mainly in patients with ANCA-associated vasculitis...
May 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28388935/direct-acting-antiviral-agents-in-the-therapy-of-hepatitis-c-virus-related-mixed-cryoglobulinaemia-a-single-centre-experience
#7
Gianfranco Lauletta, Sabino Russi, Fabio Pavone, Angelo Vacca, Franco Dammacco
BACKGROUND: The efficacy and safety of direct-acting antiviral agents (DAAs) were evaluated in a cohort of prospectively enrolled patients with hepatitis C virus (HCV)-related mixed cryoglobulinaemia (MC), an immune complex-mediated vasculitis of small and medium vessels in which the pathogenetic role of HCV has been clearly established. METHODS: Twenty-two patients received DAAs. Clinical and laboratory features were recorded at baseline, every 4 weeks until the end of treatment (EoT), and 12 weeks afterwards...
April 8, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28374231/neurological-manifestations-of-igg4-related-disease
#8
REVIEW
Bernardo Baptista, Alina Casian, Harsha Gunawardena, David D'Cruz, Claire M Rice
IgG4-related disease (IgG4-RD) is a multisystem inflammatory disorder. Early recognition of IgG4-RD is important to avoid permanent organ dysfunction and disability. Neurological involvement by IgG4-RD is relatively uncommon, but well recognised-hypertrophic pachymeningitis and hypophysitis are the most frequent manifestations. Although the nervous system may be involved in isolation, this more frequently occurs in conjunction with involvement of other systems. Elevated circulating levels of IgG4 are suggestive of the condition, but these are not pathognomonic and exclusion of other inflammatory disorders including vasculitis is required...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28368978/cryoglobulinemia-vasculitis-how-to-handle
#9
Anne C Desbois, Cloe Comarmond, David Saadoun, Patrice Cacoub
PURPOSE OF REVIEW: More than 50% of hepatitis C virus (HCV) infected patients produce a mixed cryoglobulin and two-third of them will develop a symptomatic cryoglobulinemia vasculitis (CryoVas). In the present review, we aim at summarizing the most recent advances in diagnosis and treatment of HCV-CryoVas. RECENT FINDINGS: The treatment of HCV-CryoVas has much changed during the last months. The recent emergence of new direct-acting (DAA) interferon (IFN)-free antivirals, enabling high cure rates with a very good safety profile now permit to cure most patients with HCV-CryoVas...
March 31, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28348948/microscopic-polyangiitis-atypical-presentation-with-extensive-small-bowel-necrosis-diffuse-alveolar-hemorrhage-and-renal-failure
#10
Justin M Segraves, Vivek N Iyer
Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. The patient was initially diagnosed with acute pancreatitis at an outside facility given his severe abdominal pain and elevated pancreatic enzymes...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28291241/efficacy-and-safety-of-direct-acting-antivirals-for-the-treatment-of-mixed-cryoglobulinemia
#11
Joel S Emery, Magdalena Kuczynski, Danie La, Saeed Almarzooqi, Matthew Kowgier, Hemant Shah, David Wong, Harry L A Janssen, Jordan J Feld
OBJECTIVES: Mixed cryoglobulinemia is strongly associated with hepatitis C virus (HCV) infection and ranges from being asymptomatic to causing life-threatening vasculitis. In those with symptoms, treatment with pegylated interferon (pegIFN) and ribavirin (RBV) reduces mortality. However, few data are available on the safety and efficacy of antiviral therapy with direct acting antivirals (DAAs) in the treatment of HCV-related cryoglobulinemia. METHODS: Patients treated for HCV-related cryoglobulinemia with DAA±pegIFN were retrospectively evaluated at a tertiary care center...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28270229/rituximab-versus-azathioprine-as-therapy-for-maintenance-of-remission-for-anti-neutrophil-cytoplasm-antibody-associated-vasculitis-ritazarem-study-protocol-for-a-randomized-controlled-trial
#12
Seerapani Gopaluni, Rona M Smith, Michelle Lewin, Carol A McAlear, Kim Mynard, Rachel B Jones, Ulrich Specks, Peter A Merkel, David R W Jayne
BACKGROUND: Rituximab is effective as therapy for induction of remission in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, the effect of rituximab is not sustained, and subsequent relapse rates are high, especially in patients with a history of relapse. There is a need to identify whether maintenance therapy with rituximab is superior to the current standard of azathioprine or methotrexate for prevention of relapse following induction with rituximab...
March 7, 2017: Trials
https://www.readbyqxmd.com/read/28219772/evidence-based-recommendations-on-the-management-of-extrahepatic-manifestations-of-chronic-hepatitis-c-virus-infection
#13
REVIEW
Manuel Ramos-Casals, Anna Linda Zignego, Clodoveo Ferri, Pilar Brito-Zerón, Soledad Retamozo, Milvia Casato, Peter Lamprecht, Alessandra Mangia, David Saadoun, Athanasios G Tzioufas, Zobair M Younossi, Patrice Cacoub
No abstract text is available yet for this article.
February 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28217942/hypertrophic-pachymeningitis-is-a-characteristic-manifestation-of-granulomatosis-with-polyangiitis-a-retrospective-study-of-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis
#14
Yasuhiro Shimojima, Dai Kishida, Akiyo Hineno, Masahide Yazaki, Yoshiki Sekijima, Shu-Ichi Ikeda
AIM: To elucidate the characteristics of patients with hypertrophic pachymeningitis (HP) in a population with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: We retrospectively investigated the clinical records of 39 patients who were diagnosed with AAV. To determine the characteristics of HP in AAV, the epidemiological and clinical data from patients with HP were statistically compared with those from patients without HP. RESULTS: Of 39 patients with AAV, seven (17...
February 20, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28210182/successful-cataract-surgery-in-a-patient-with-refractory-wegener-s-granulomatosis-effectively-treated-with-rituximab-a-case-report
#15
Abdullah M Alfawaz
Wegener's granulomatosis is a granulomatous disorder associated with systemic necrotizing vasculitis. Eye involvement occurs in approximately 50% of Wegener's granulomatosis patients and is an important cause of morbidity. Conventional treatment-related morbidity and failure have led to studies of alternative treatment modalities. In this case of a 35-year-old man with severe Wegener's granulomatosis, conventional therapy failed to induce remission. Despite the standard immunosuppressive therapy, progression of the disease was observed, mainly with ocular manifestations and renal impairment...
July 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28203574/resolution-of-q-fever-associated-cryoglobulinemia-with-anti-cd20-monoclonal-antibody-treatment
#16
Kellie L Hawkins, Edward N Janoff, Robert W Janson
Immunologic phenomena can complicate chronic infections with Coxiella burnetii (Q fever), including immune complex deposition causing vasculitis, neuropathy, and glomerulonephritis. We describe the case of a man with Q fever endocarditis, mixed cryoglobulinemia, and life-threatening vasculitis driven by immune complex deposition who was successfully treated with B cell depleting therapy (rituximab).
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28202741/seasonal-influence-on-the-risk-of-relapse-at-a-rise-of-antineutrophil-cytoplasmic-antibodies-in-vasculitis-patients-with-renal-involvement
#17
Michael J Kemna, Jan Willem Cohen Tervaert, Kelly Broen, Sjoerd A M E G Timmermans, Pieter van Paassen, Jan G M C Damoiseaux
OBJECTIVE: The objective of this study was to identify risk factors for a relapse at the time of an increase in antineutrophil cytoplasmic antibodies (ANCA) in patients with renal ANCA-associated vasculitis (AAV). METHODS: All patients between January 2000 and November 2011 with renal AAV having an ANCA rise during remission were included. Differences in time to relapse since the ANCA rise were assessed using a Cox regression model. The level of 25-hydroxy Vitamin D (25(OH)D) was assessed at the ANCA rise and at a subsequent relapse or time-matched during remission...
February 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28155022/rituximab-in-anca-associated-vasculitis
#18
REVIEW
Romina I Hassan, Angelo L Gaffo
PURPOSE OF REVIEW: The purpose of this review is to describe the efficacy and safety of rituximab (RTX) as a remission induction and maintenance therapy in ANCA-associated vasculitis (AAV). RECENT FINDINGS: A PubMed search was carried out to track down articles published between February 2006 and February 2016. Randomized controlled trials (RCTs) that encompassed patients with AAV were included. The American College of Rheumatology (ACR) and the European League against Rheumatism (EULAR) 2014-2015 online abstracts were also reviewed whether they were RTCs or not...
February 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28148583/anca-associated-vasculitis
#19
Max Yates, Richard Watts
The vasculitides are a heterogeneous group of conditions typified by their ability to cause vessel inflammation with or without necrosis. They present with a wide variety of signs and symptoms and, if left untreated, carry a significant burden of mortality and morbidity. The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are three separate conditions - granulomatosis with polyangiitis (GPA; formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA; previously known as Churg-Strauss syndrome)...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28134075/cyclophosphamide-followed-by-rituximab-for-aggressive-multiple-relapsing-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#20
Sophia Lionaki, George E Fragoulis, Aliki Venetsanopoulou, Panagiotis Vlachoyiannopoulos, John N Boletis, Athanasios G Tzioufas
OBJECTIVES: To evaluate the long term outcomes of patients with multi-relapsing antineutrophil cytoplasmic antibody-associated vasculitis (AAV), who received sequentially therapy with cyclophosphamide and rituximab, upon new onset of aggressive vasculitis. METHODS: We retrospectively studied patients with multiple-relapsing AAV, who were treated with the standard regimen plus rituximab, given in sequence, upon a major relapse, compared to historical patients, who had been treated with the standard regimen alone in the same setting...
January 25, 2017: Clinical and Experimental Rheumatology
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