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Keywords timing of initiation of calcin...

timing of initiation of calcineurin inhibitors

https://read.qxmd.com/read/38488776/effect-of-letermovir-initiation-on-tacrolimus-concentrations-among-lung-transplant-recipients-receiving-concomitant-azole-antifungal-prophylaxis
#1
JOURNAL ARTICLE
Kellie J Goodlet, Rhiannon Garcia
BACKGROUND: The antiviral letermovir has been increasingly used as off-label cytomegalovirus prophylaxis in solid organ transplant recipients. Observational studies have reported notable increases in tacrolimus (FK) exposure following letermovir; however, whether a significant interaction occurs in the setting of existing moderate-to-strong CYP3A4 inhibition is unknown. Therefore, the purpose of this study was to evaluate FK trough changes before and after letermovir among lung transplant recipients receiving azole antifungal prophylaxis...
March 15, 2024: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/38450793/leflunomide-as-adjunct-therapy-for-bk-viremia-management-in-pediatric-kidney-transplant-recipients
#2
JOURNAL ARTICLE
Alexandra Aldieri, Mary Chandran, Debora Matossian, Aparna Hariprasad, Bliss Magella, Danielle Lazear, Eliza Blanchette, Eric Benz, Margret Bock
BACKGROUND: BK viremia after kidney transplantation (KT) poses significant risk for BK virus-associated nephropathy and impacts graft survival. Conventional treatment involves reduction of immunosuppression, which in turn may increase risk for rejection. To address this dilemma, use of anti-viral therapy with immunosuppressive properties such as leflunomide is an attractive option. METHODS: We performed a multi-center, retrospective chart review to report tolerability and effectiveness of leflunomide use for the eradication of BK viremia and prevention of BK virus-associated nephropathy in pediatric KT recipients...
March 2024: Pediatric Transplantation
https://read.qxmd.com/read/38403699/-a-case-of-clinically-amyopathic-dermamyositis-with-interstitial-lung-disease-showing-two-deteriorations-in-4-years
#3
JOURNAL ARTICLE
Takashi Yamane, Tomoyuki Urata
We report the case of a 45-year-old man who was diagnosed with clinically amyopathic dermamyositis (CADM) and interstitial lung disease (ILD) after presenting with skin lesions typical of CADM and testing positive for anti-Melanoma Diferentiation-Associated gene 5 (anti-MDA5) anti-bodies. He was treated with a regimen including steroid pulse therapy, intravenous cyclophosphamide (IVCY), and calcineurin Inhibitor drug, which initially improved his ILD. However, three months post-treatment, the first deterioration of his conditions occurred, necessitating further administration of steroid pulse therapy and IVCY...
2024: Arerugī, [Allergy]
https://read.qxmd.com/read/38401202/real-world-management-of-patients-with-neuromyelitis-optica-spectrum-disorder-using-satralizumab-results-from-a-japanese-claims-database
#4
JOURNAL ARTICLE
Ichiro Nakashima, Jin Nakahara, Hideo Yasunaga, Masami Yamashita, Nobuo Nishijima, Atsushi Satomura, Mariko Nio, Kazuo Fujihara
BACKGROUND: Satralizumab, a humanized anti-interleukin-6 receptor monoclonal antibody, has been approved globally for the treatment of neuromyelitis optica spectrum disorder (NMOSD), based on positive results from two randomized, double-blind, phase 3 studies: SAkuraSky (NCT02028884) and SAkuraStar (NCT02073279). There remains an unmet need to understand the real-world management of NMOSD, especially in patients undergoing tapering of concomitant therapy. We examined real-world treatment patterns, including concomitant glucocorticoids and immunosuppressants, and relapse in satralizumab-treated patients with NMOSD, using a Japanese administrative hospital claims database...
February 12, 2024: Multiple Sclerosis and related Disorders
https://read.qxmd.com/read/38274509/post-liver-transplant-renal-dysfunction-evaluation-management-and-immunosuppressive-practice
#5
REVIEW
Kaiser Raja, Charles Panackel
Liver transplantation (LT) is an effective and lifesaving treatment for patients with end-stage liver disease and hepatocellular carcinoma. Significant improvement in intermediate and long-term survival has been possible due to advancements in immunosuppressive therapy, perioperative care, and surgical techniques. Despite these advances, metabolic complications, including diabetes mellitus, cardiovascular diseases, malignancies, and renal dysfunction, are challenging issues after LT. Acute kidney injury (AKI) and chronic kidney disease (CKD) after LT are common and result in significant morbidity and mortality...
2024: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/38251484/impact-of-low-disease-activity-remission-and-complete-remission-on-flares-following-tapering-of-corticosteroids-and-immunosuppressive-therapy-in-patients-with-systemic-lupus-erythematous-a-multinational-cohort-study
#6
JOURNAL ARTICLE
Jiacai Cho, Liang Shen, Molla Huq, Rangi Kandane-Rathnayake, Vera Golder, Worawit Louthrenoo, Yi-Hsing Chen, Laniyati Hamijoyo, Shue-Fen Luo, Yeong-Jian J Wu, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Masayoshi Harigai, Yanjie Hao, Zhuoli Zhang, Duminda Basnayake, Madelynn Chan, Jun Kikuchi, Tsutomu Takeuchi, Sang-Cheol Bae, Shereen Oon, Sean O'Neill, Fiona Goldblatt, Kristine Pek Ling Ng, Annie Law, Nicola Tugnet, Sunil Kumar, Cherica Tee, Michael Tee, Naoaki Ohkubo, Yoshiya Tanaka, Sandra V Navarra, Chak Sing Lau, Alberta Hoi, Eric F Morand, Mandana Nikpour, Aisha Lateef
BACKGROUND: Targets of treatment for systemic lupus erythematosus (SLE) include the Lupus Low Disease Activity State (LLDAS), remission, and complete remission. Whether treatment can be tapered after attaining these targets and whether tapering is safer in patients in complete remission compared with LLDAS are unknown. We aimed to assess the odds of disease flares after treatment tapering in stable disease, versus continuing the same therapy. We also aimed to examine whether tapering in complete remission resulted in fewer flares or longer time to flare compared with tapering in LLDAS or remission...
October 2023: Lancet Rheumatology
https://read.qxmd.com/read/38231719/clinico-biochemical-profile-of-biopsy-proven-minimal-change-disease-in-adults-from-a-tertiary-care-center-in-south-india
#7
JOURNAL ARTICLE
Karteek R N Udupa, Mahesh Eshwarappa, K C Gurudev, M S Gireesh, Rajshekar Reddy, Mohammed Yousuff
Minimal change disease (MCD) is the most common cause of nephrotic syndrome (NS) in children, and in adults, it contributes to 10%-25% of NS. MCD in adults follows a slightly different course associated with increased incidence of steroid resistance, hematuria, and HTN. This is a prospective-record analysis study aimed to analyze the profile of MCD in adults, response to treatment, and relapse rates. A retrospective observational study was carried out and data were collected retrospectively from all biopsy-proven MCD patients between 2012 and 2018...
May 1, 2023: Saudi Journal of Kidney Diseases and Transplantation
https://read.qxmd.com/read/37891020/sirolimus-long-term-tolerability-and-impact-on-kidney-function-in-lung-transplantation-a-single-center-experience
#8
JOURNAL ARTICLE
Ashley A Feist, Mark Mariski, Linda Awdishu, Michelle Bremer, Gordon Yung, Chris Jung, Eugene Golts, Kamyar Afshar
BACKGROUND: After lung transplant, 2 common complications are calcineurin inhibitor (CNI) induced nephrotoxicity and bronchiolitis obliterans syndrome. The objective of this study was to investigate the long-term effects of sirolimus conversion after lung transplantation. METHODS: This was a retrospective cohort study of patients who had undergone lung transplantation at a single center from June 2003 to December 2016. We compared patients converted to a sirolimus-based regimen to those maintained on our standard tacrolimus-based regimen...
October 25, 2023: Transplantation Proceedings
https://read.qxmd.com/read/37722533/cyclosporine-vs-tacrolimus-after-liver-transplantation-for-primary-sclerosing-cholangitis-a-propensity-score-matched-intention-to-treat-analysis
#9
JOURNAL ARTICLE
Fredrik Åberg, Ville Sallinen, Samuli Tuominen, René Adam, Vincent Karam, Darius Mirza, Michael A Heneghan, Pål-Dag Line, William Bennet, Bo-Göran Ericzon, Michal Grat, Peter Lodge, Allan Rasmussen, Moritz Schmelzle, Douglas Thorburn, Constantino Fondevila, Ilkka Helanterä, Arno Nordin
BACKGROUND & AIMS: There is controversy regarding the optimal calcineurin inhibitor type after liver transplant(ation) (LT) for primary sclerosing cholangitis (PSC). We compared tacrolimus with cyclosporine in a propensity score-matched intention-to-treat analysis based on registries representing nearly all LTs in Europe and the US. METHODS: From the European Liver Transplant Registry (ELTR) and Scientific Registry of Transplant Recipients (SRTR), we included adult patients with PSC undergoing a primary LT between 2000-2020...
January 2024: Journal of Hepatology
https://read.qxmd.com/read/37548877/real-world-treatment-patterns-in-patients-with-vitiligo-in-the-united-states
#10
JOURNAL ARTICLE
David Rosmarin, Ahmed Soliman, Chao Li
INTRODUCTION: Vitiligo is an autoimmune disorder resulting in skin depigmentation, with limited approved treatment options. This study evaluated medication utilization and treatment patterns among patients in the first year following vitiligo diagnosis. METHODS: This retrospective analysis of claims data from the Merative® MarketScan Research Databases included patients aged ≥ 12 years newly diagnosed with vitiligo. Patients were identified between October 1, 2016, and April 30, 2021, and had ≥ 12 months of continuous enrollment pre- and post-vitiligo diagnosis...
August 7, 2023: Dermatology and Therapy
https://read.qxmd.com/read/37544752/combination-of-prednisolone-and-calcineurin-inhibitors-prevents-lung-function-decline-in-patients-with-anti-aminoacyl-trna-synthetase-antibody-positive-polymyositis-dermatomyositis
#11
JOURNAL ARTICLE
Yuki Yorishima, Masaki Tominaga, Kiminori Fujimoto, Shuji Nagata, Akiko Sumi, Tomonori Chikasue, Masaki Okamoto, Shinjiro Kaieda, Goushi Matama, Yoshiaki Zaizen, Hitoshi Obara, Tatsuyuki Kakuma, Hiroaki Ida, Tomotaka Kawayama, Tomoaki Hoshino
OBJECTIVE: Anti-aminoacyl-tRNA synthetase antibody-positive polymyositis/dermatomyositis-associ ated interstitial lung disease (ARS-ILD) has a good prognosis, with few cases progressing to respiratory failure. This study aimed to determine factors predictive of lung function changes in patients with ARS-ILD. METHODS: We retrospectively studied 49 patients with ARS-ILD treated at Kurume University Hospital Hospital between 2000 and 2018. We followed 30 patients for more than 2 years after prednisolone (PSL) therapy, with or without calcineurin inhibitors (CNIs), evaluating clinical, physiological, computed tomography, pulmonary func tion, and serological data...
August 7, 2023: Kurume Medical Journal
https://read.qxmd.com/read/37528492/calcineurin-inhibition-protects-against-dopamine-toxicity-and-attenuates-behavioral-decline-in-a-parkinson-s-disease-model
#12
JOURNAL ARTICLE
Rupsha Mondal, Chayan Banerjee, Sumangal Nandy, Moumita Roy, Joy Chakraborty
BACKGROUND: Parkinson's disease (PD), a highly prevalent neuro-motor disorder is caused due to progressive loss of dopaminergic (DAergic) neurons at substantia nigra region of brain. This leads to depleted dopamine (DA) content at striatum, thus affecting the fine tuning of basal ganglia. In patients, this imbalance is manifested by akinesia, catalepsy and tremor. PD associated behavioral dysfunctions are frequently mitigated by l-DOPA (LD) therapy, a precursor for DA synthesis. Due to progressive neurodegeneration, LD eventually loses applicability in PD...
August 1, 2023: Cell & Bioscience
https://read.qxmd.com/read/37280416/association-between-the-use-of-topical-calcineurin-inhibitors-and-the-risk-of-cancer-among-patients-with-atopic-dermatitis-a-nationwide-population-based-retrospective-cohort-study
#13
JOURNAL ARTICLE
Hao-Hsin Huang, Dereck Shen, Tom C Chan, Yung-Tsu Cho, Chao-Hsiun Tang, Chia-Yu Chu
IMPORTANCE: The cancer risks associated with treatment with topical calcineurin inhibitors (TCIs) in patients with atopic dermatitis (AD) remain controversial, and limited evidence exists regarding the cancer risks among patients with AD treated with TCIs in Asian populations. OBJECTIVES: This study identified the association between TCI use and the risks of developing all cancers, lymphoma, skin cancers, and other cancers. DESIGN: This study was a nationwide, population-based, retrospective cohort study...
June 6, 2023: American Journal of Clinical Dermatology
https://read.qxmd.com/read/37200357/development-of-a-cell-free-screening-assay-for-the-identification-of-direct-perk-activators
#14
JOURNAL ARTICLE
Márcia F D Costa, Günter U Höglinger, Thomas W Rösler
The activation of the unfolded protein response, particularly via the PERK pathway, has been suggested as a promising therapeutic approach in tauopathies, a group of neurodegenerative disorders characterized by the abnormal phosphorylation and aggregation of tau protein. So far, a shortage of available direct PERK activators has been limiting the progresses in this field. Our study aimed at the development of a cell-free screening assay enabling the detection of novel direct PERK activators. By applying the catalytic domain of recombinant human PERK, we initially determined ideal conditions of the kinase assay reaction, including parameters such as optimal kinase concentration, temperature, and reaction time...
2023: PloS One
https://read.qxmd.com/read/37042314/implementation-of-clinical-cyp3a-genotyping-for-tacrolimus-dosing-in-a-large-kidney-transplant-program
#15
JOURNAL ARTICLE
Emma Tillman, Miley G Nikirk, Jeanne Chen, Todd C Skaar, Tyler Shugg, Judith P Maddatu, Asif A Sharfuddin, Michael T Eadon
Tacrolimus is a calcineurin inhibitor with a narrow therapeutic range and metabolized by cytochrome P450 (CYP) isoenzymes CYP3A4 and CYP3A5. The Clinical Pharmacogenetic Implementation Consortium (CPIC) published evidence-based guidelines for CYP3A5 normal/intermediate metabolizers prescribed tacrolimus, yet few transplant centers have implemented routine testing. The objective of this study was to implement preemptive CYP3A genotyping into clinical practice in a large kidney transplant program and to evaluate workflow feasibility, potential clinical benefit, and reimbursement to identify barriers and determine sustainability...
April 12, 2023: Journal of Clinical Pharmacology
https://read.qxmd.com/read/37031049/preclinical-safety-evaluation-of-calcineurin-inhibitors-delivered-through-an-intraductal-route-to-prevent-post-ercp-pancreatitis-demonstrates-endocrine-and-systemic-safety
#16
JOURNAL ARTICLE
Jianbo Ni, Asna Khalid, Yu-Chu Lin, Monique T Barakat, Jing Wang, Cheng-Yu Tsai, Pasha Reza Shams Azar, Ying Ding, Judy-April Murayi, Thottala Jayaraman, Ronald Poropatich, Rita Bottino, Li Wen, Georgios I Papachristou, Gayathri Swaminathan, Mang Yu, Sohail Z Husain
OBJECTIVE: There is an urgent need for safe and targeted interventions to mitigate post-ERCP pancreatitis (PEP). Calcineurin inhibitors (CnIs) offer therapeutic promise as calcineurin signaling within acinar cells is a key initiating event in PEP. In previous proof-of-concept studies using experimental models, we showed that concurrent intra-pancreatic ductal administration of the CnIs, tacrolimus (Tac) or cyclosporine A (CsA) with the ERCP radiocontrast agent (RC) prevented PEP. To translate this finding clinically, we investigated potential toxic effects of intraductal delivery of a single-dose RC-CnI formulation on endocrine pancreas function and systemic toxicities in a preclinical PEP model...
March 30, 2023: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://read.qxmd.com/read/36938631/comparative-analysis-of-the-efficacy-of-different-treatments-for-idiopathic-membranous-nephropathy-a-retrospectively-real-world-study
#17
JOURNAL ARTICLE
Mengyao Sun, Jing Huang, Jianwei Dong, Zhuo Li, Chaofan Li, Shasha Zhang, Bing Chen
BACKGROUND: This study aimed to explore the clinical efficacy of different treatment regimens for idiopathic membranous nephropathy (IMN). METHODS: Patients with IMN were retrospectively analyzed by dividing into two groups: glucocorticoids combined with cyclophosphamide group (GC + CYC) and glucocorticoids combined with calcineurin inhibitor group (GC + CNIs). After 1 year of treatment, those who found that the initial treatment was not effective were switched to another regimen...
March 20, 2023: Current Medical Research and Opinion
https://read.qxmd.com/read/36927191/combination-strategies-for-lupus-nephritis-facts-and-controversies
#18
JOURNAL ARTICLE
Chi Chiu Mok
INTRODUCTION: There is an unmet need to improve the efficacy of therapeutic regimens in lupus nephritis (LN). Cocktail immunosuppressive therapy for the synergistic effect of individual drugs may enhance efficacy and enable dosage reduction. However, the potential increase in the risk of serious and opportunistic infections is a concern. Moreover, the timing of combination therapy, adoption of a step-up or step-down approach, and the choice of drugs is still controversial, partly related to the cost-effectiveness issue...
May 2023: Expert Review of Clinical Immunology
https://read.qxmd.com/read/36718275/belimumab-treatment-in-autoimmune-hepatitis-and-primary-biliary-cholangitis-a-case-series
#19
JOURNAL ARTICLE
Mirjam Kolev, Adela-Cristina Sarbu, Burkhard Möller, Britta Maurer, Florian Kollert, Nasser Semmo
BACKGROUND: The majority of patients with autoimmune hepatitis (AIH) achieve complete remission with established treatment regiments. In patients with intolerance or insufficient response to these drugs, the remaining options are limited and novel treatment approaches necessary. In primary biliary cholangitis (PBC), ursodeoxycholic acid (UDCA) and fibrates have improved prognosis dramatically, but there remains a proportion of patients with refractory disease.In patients with refractory AIH and/or PBC, we used a novel treatment strategy with the anti -B cell activating factor, belimumab...
2023: Journal of translational autoimmunity
https://read.qxmd.com/read/36641051/drug-drug-interactions-of-ritonavir-boosted-sars-cov-2-protease-inhibitors-in-solid-organ-transplant-recipients-experience-from-the-initial-use-of-lopinavir-ritonavir
#20
JOURNAL ARTICLE
Gonzalez-García R, Joan-Ramon Roma, María Rodríguez-García, Natalia Arranz, Juan Ambrosioni, Marta Bodro, Maria-Ángeles Castel, Federic Cofan, Gonzalo Crespo, Fritz Diekmann, Marta Farrero, Alejandro Forner, Ana LLigoña, Ma Ángeles Marcos, Asunción Moreno, Pablo Ruiz, Dolors Soy, Mercè Brunet, Jose M Miró, Montse Tuset
OBJECTIVES: To review the drug interactions (DDI) between tacrolimus and lopinavir/ritonavir (LPV/r) in 23 solid organ transplant (SOT) patients during the first wave of COVID-19 and the efficacy and safety of prednisone monotherapy. METHODS: Observational study performed between March-June 2022 in SOT recipients admitted with a diagnosis of SARS-CoV-2 infection who received LPV/r (≥2 doses). Once LPV/r was started, their calcineurin inhibitor (CNI) treatment was temporarily switched to prednisone monotherapy (15-20 mg/day) to avoid DDI and toxicity...
January 11, 2023: Clinical Microbiology and Infection
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