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Azathioprine treatment for ILD

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https://www.readbyqxmd.com/read/27252419/rituximab-in-the-treatment-of-jo1-antibody-associated-antisynthetase-syndrome-anti-ro52-positivity-as-a-marker-for-severity-and-treatment-response
#1
Jutta Bauhammer, Norbert Blank, Regina Max, Hanns-Martin Lorenz, Ulrich Wagner, Dietmar Krause, Christoph Fiehn
OBJECTIVE: Rituximab (RTX) has been used successfully for the treatment of severe Jo1 antibody-associated antisynthetase syndrome. The aim of this retrospective study was to evaluate the effect of RTX in severe Jo1 antisynthetase syndrome and determine predictive factors for response. METHODS: There were 61 patients with Jo1 antisynthetase syndrome identified; 18 of these received RTX. One patient was lost to followup. The remaining 17 patients and 30 out of 43 patients who were treated with conventional immunosuppressive (IS) drugs were followed for a mean of 35 months and 84 months, respectively...
August 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27049330/mycophenolate-mofetil-is-an-effective-and-safe-option-for-the-management-of-systemic-sclerosis-associated-interstitial-lung-disease-results-from-the-australian-scleroderma-cohort-study
#2
Claire Owen, Gene-Siew Ngian, Kathleen Elford, Owen Moore, Wendy Stevens, Mandana Nikpour, Candice Rabusa, Susanna Proudman, Janet Roddy, Jane Zochling, Catherine Hill, Allan Sturgess, Kathleen Tymms, Peter Youssef, Joanne Sahhar
OBJECTIVES: To report the efficacy and tolerability of mycophenolate mofetil (MMF) and azathioprine (AZA) in the management of systemic sclerosis-associated interstitial lung disease (SSc-ILD). METHODS: Patients in the Australian Scleroderma Cohort Study treated with at least 3 months of MMF or AZA for SSc-ILD confirmed on high resolution computed tomography (HRCT) chest were identified and their pulmonary function tests (PFTs) retrieved. Individuals with available results for T-1 (12 months prior to treatment commencement), T0 (date of treatment commencement) and at least one subsequent time point were included in the drug efficacy analysis...
September 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/26557259/organisation-of-diagnosis-and-treatment-of-idiopathic-pulmonary-fibrosis-and-other-interstitial-lung-diseases-in-the-nordic-countries
#3
Elisabeth Bendstrup, Charlotte Hyldgaard, Alan Altraja, Tone Sjåheim, Marjukka Myllärniemi, Gunnar Gudmundsson, Magnus Sköld, Ole Hilberg
INTRODUCTION: Differences in the organisation of idiopathic pulmonary fibrosis (IPF) and interstitial lung diseases (ILDs) in the Nordic countries are not well described. Diagnostic setups, treatment modalities and follow-up plans may vary due to national, cultural and epidemiological features. The aim of the present study was to describe the different organisation of diagnostics and treatment of IPF and ILD in the Nordic countries. METHODS: All university and regional hospitals with respiratory physicians were invited to respond to a questionnaire collecting data on the number of physicians, nurses, patients with ILD/IPF, the presence of and adherence to disease-specific national and international guidelines, diagnosis and treatment including ILD-specific palliation and rehabilitation programmes...
2015: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/26324802/interstitial-lung-disease-in-systemic-sclerosis-where-do-we-stand
#4
REVIEW
Susanna Cappelli, Silvia Bellando Randone, Gianna Camiciottoli, Amato De Paulis, Serena Guiducci, Marco Matucci-Cerinic
Interstitial lung disease (ILD) is common in systemic sclerosis (SSc) patients and despite recent advances in the treatment is, at present, the major cause of death. Today, an early diagnosis of ILD is possible, and is mandatory to improve the prognosis of the disease. Pulmonary function tests and high-resolution computed tomography remain the mainstay for the diagnosis of SSc-ILD, but there is a growing interest in lung ultrasound. Recently, the correlation between severity of fibrosis and some peripheral blood biomarkers has been described...
September 2015: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/26313852/treatment-of-inflammatory-myopathy-emerging-therapies-and-therapeutic-targets
#5
REVIEW
Siamak Moghadam-Kia, Rohit Aggarwal, Chester V Oddis
Despite the lack of placebo-controlled trials, glucocorticoids are considered the mainstay of initial treatment for idiopathic inflammatory myopathy and myositis-associated interstitial lung disease. Glucocorticoid-sparing agents are often given concomitantly with other immunosuppressive agents, particularly in patients with moderate or severe disease. First-line conventional immunosuppressive drugs include either methotrexate or azathioprine, and when they fail, more aggressive therapy includes mycophenolate mofetil, tacrolimus or cyclosporine, intravenous immunoglobulin, rituximab, or cyclophosphamide, used alone or in various combinations...
2015: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/25777803/treatment-algorithms-in-systemic-lupus-erythematosus
#6
Chayawee Muangchan, Ronald F van Vollenhoven, Sasha R Bernatsky, C Douglas Smith, Marie Hudson, Murat Inanç, Naomi F Rothfield, Peter T Nash, Richard A Furie, Jean-Luc Senécal, Vinod Chandran, Ruben Burgos-Vargas, Rosalind Ramsey-Goldman, Janet E Pope
OBJECTIVE: To establish agreement on systemic lupus erythematosus (SLE) treatment. METHODS: SLE experts (n = 69) were e-mailed scenarios and indicated preferred treatments. Algorithms were constructed and agreement determined (≥50% respondents indicating ≥70% agreement). RESULTS: Initially, 54% (n = 37) responded suggesting treatment for scenarios; 13 experts rated agreement with scenarios. Fourteen of 16 scenarios had agreement as follows: discoid lupus: first-line therapy was topical agents and hydroxychloroquine and/or glucocorticoids then azathioprine and subsequently mycophenolate (mofetil); uncomplicated cutaneous vasculitis: initial treatment was glucocorticoids ± hydroxychloroquine ± methotrexate, followed by azathioprine or mycophenolate and then cyclophosphamide; arthritis: initial therapy was hydroxychloroquine and/or glucocorticoids, then methotrexate and subsequently rituximab; pericarditis: first-line therapy was nonsteroidal antiinflammatory drugs, then glucocorticoids with/without hydroxychloroquine, then azathioprine, mycophenolate, or methotrexate and finally belimumab or rituximab, and/or a pericardial window; interstitial lung disease/alveolitis: induction was glucocorticoids and mycophenolate or cyclophosphamide, then rituximab or intravenous gamma globulin (IVIG), and maintenance followed with azathioprine or mycophenolate; pulmonary hypertension: glucocorticoids and mycophenolate or cyclophosphamide and an endothelin receptor antagonist were initial therapies, subsequent treatments were phosphodiesterase-5 inhibitors and then prostanoids and rituximab; antiphospholipid antibody syndrome: standard anticoagulation with/without hydroxychloroquine, then a thrombin inhibitor for venous thrombosis, versus adding aspirin or platelet inhibition drugs for arterial events; mononeuritis multiplex and central nervous system vasculitis: first-line therapy was glucocorticoids and cyclophosphamide followed by maintenance with azathioprine or mycophenolate, and then rituximab, IVIG, or plasmapheresis; and serious lupus nephritis: first-line therapy was glucocorticoids and mycophenolate, then cyclophosphamide then rituximab...
September 2015: Arthritis Care & Research
https://www.readbyqxmd.com/read/25620556/-mechanic-s-hands-during-antisynthetase-syndrome-a-marker-of-systemic-involvement
#7
O Nahas, F Haddad, G Maalouly
BACKGROUND: Antisynthetase syndrome is characterized by the presence of interstitial lung disease, inflammatory myopathy, joint disease, Raynaud's phenomenon and characteristic skin lesions of the hands known as "mechanic's hands" associated with the presence of serum antibody to aminoacyl transfer-RNA synthetases. We report the case of a patient in whom cutaneous relapse consistently preceded CT evidence of pulmonary fibrosis flare-up. PATIENT AND METHODS: A 56-year-old patient consulted for recent exertional dyspnoea and dry cough...
March 2015: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/25432871/-therapeutic-relevance-of-hrct-findings-from-a-pneumological-viewpoint
#8
R Suchy, M Pfeifer
The high-resolution computed tomography (HRCT) technique is an essential component in diagnosing interstitial lung disease (ILD) as it provides important and specialized information and a much greater accuracy than chest X-rays. It contributes to a narrowing down of the differential diagnoses and is also important for planning further invasive investigations, e.g. bronchoscopy, bronchoalveolar lavage, transbronchial lung biopsy and surgical lung biopsy, if needed. An accurate diagnosis of ILD is based on a multidisciplinary discussion involving pulmonologists, radiologists and pathologists experienced in the diagnosis of ILD...
December 2014: Der Radiologe
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