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https://www.readbyqxmd.com/read/29781586/treatment-algorithms-for-systemic-sclerosis-according-to-experts
#1
Andreu Fernández-Codina, Kyle M Walker, Janet E Pope
INTRODUCTION: Treatment for many aspects of systemic sclerosis (SSc) lacks agreement. OBJECTIVES: To generate SSc treatment algorithms endorsed by high percentage of SSc experts. METHODS: Experts from the Scleroderma Clinical Trials Consortium and the Canadian Scleroderma Research group (N=170) were asked whether they agreed with SSc algorithms (from 2012). Two consensus rounds refined agreement; 62 (36%), 54 (32%) and 48 (28%) experts completed surveys...
May 21, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29780690/an-update-on-the-treatment-of-pediatric-autoimmune-encephalitis
#2
Cory Stingl, Kathleen Cardinale, Heather Van Mater
Purpose of review: Autoimmune encephalitis (AE) is an increasingly recognized etiology for neuropsychiatric deficits that are highly responsive to immunotherapy. As a result, rheumatologists are often called upon to help with the diagnosis and treatment of these conditions. The purpose of this review is to provide an update on the pharmacologic treatment of AE. Recent findings: To date, there are no prospective randomized placebo-controlled trials to guide treatment recommendations for AE...
March 2018: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29773271/juvenile-idiopathic-arthritis-associated-uveitis
#3
REVIEW
Ethan S Sen, A V Ramanan
Juvenile idiopathic arthritis (JIA) is the commonest rheumatic disease in children and JIA-associated uveitis its most frequent extra-articular manifestation. The uveitis is potentially sight-threatening and thus carries a considerable risk of morbidity with associated reduction in quality of life. The commonest form of uveitis seen in association with JIA is chronic anterior uveitis, which is almost always asymptomatic in the initial stages. Therefore, screening for JIA-associated uveitis in at-risk patients is essential...
August 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29773268/recent-therapeutic-advances-in-juvenile-idiopathic-arthritis
#4
REVIEW
Gabriella Giancane, Alessandra Alongi, Silvia Rosina, Jessica Tibaldi, Alessandro Consolaro, Angelo Ravelli
Over the past two decades, the management of juvenile idiopathic arthritis (JIA) has been revolutionized by the increased tendency toward early aggressive interventions and the availability of the novel biologic medications. In 2017, three novel randomized controlled trials have evaluated the effectiveness and tolerability of golimumab and tocilizumab in polyarticular JIA, and shown that methotrexate may increase and prolong the effect of intra-articular corticosteroid injection in children with oligoarthritis...
August 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29773231/biologics-in-sapho-syndrome-a-systematic-review
#5
REVIEW
Dimitrios Daoussis, Georgia Konstantopoulou, Pantelis Kraniotis, Lazaros Sakkas, Stamatis-Nick Liossis
BACKGROUND: The SAPHO syndrome is a relatively rare clinical entity characterized by a wide range of dermatological and musculoskeletal manifestations. Biologics have been used in cases refractory to conventional treatment. METHODS: We present herein a patient with refractory to treatment SAPHO syndrome who exhibited a dramatic and fast response to IL-17 blockade. Additionally, we performed a systematic review of all cases of patients with SAPHO syndrome treated with biologics to date...
April 17, 2018: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29761122/bortezomib-treatment-for-severe-refractory-anti-nmda-receptor-encephalitis
#6
Yong-Won Shin, Soon-Tae Lee, Tae-Joon Kim, Jin-Sun Jun, Kon Chu
Objective: To evaluate the therapeutic potential of bortezomib, a proteasome inhibitor that target plasma cells, in order to revive stalled recovery in patients with anti- N -methyl-d-aspartate (NMDA) receptor encephalitis who remain bedridden even after aggressive immunotherapy. Methods: We consecutively enrolled patients with anti-NMDA receptor encephalitis who remained bedridden after first-line immunotherapy (steroids and intravenous immunoglobulin), second-line immunotherapy (rituximab), and tocilizumab treatment, and treated them with subcutaneous bortezomib...
May 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29760159/inadequate-response-to-treat-to-target-methotrexate-therapy-in-patients-with-new-onset-rheumatoid-arthritis-development-and-validation-of-clinical-predictors
#7
Xavier M Teitsma, Johannes W G Jacobs, Paco M J Welsing, Pascal H P de Jong, Johanna M W Hazes, Angelique E A M Weel, Attila Pethö-Schramm, Michelle E A Borm, Jacob M van Laar, Floris P J G Lafeber, Johannes W J Bijlsma
OBJECTIVE: To identify and validate clinical baseline predictors associated with inadequate response (IR) to methotrexate (MTX) therapy in newly diagnosed patients with rheumatoid arthritis (RA). METHODS: In U-Act-Early, 108 disease-modifying antirheumatic drug (DMARD)-naive patients with RA were randomised to initiate MTX therapy and treated to target until sustained remission (disease activity score assessing 28 joints (DAS28) <2.6 with four or less swollen joints for ≥24 weeks) was achieved...
May 14, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29759126/primary-care-vasculitis-polymyalgia-rheumatica-and-giant-cell-arteritis
#8
REVIEW
Mathilde H Pioro
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are related inflammatory diseases of adults aged 50 years or older. The diagnosis of PMR is based on morning stiffness, proximal shoulder and pelvic girdle pain, and functional impairment. GCA is characterized by headache, jaw claudication, and visual disturbances. Constitutional symptoms and elevated inflammatory markers are common to both conditions. Temporal artery biopsy remains the gold standard for diagnosis of GCA. Glucocorticoids are the cornerstone of therapy, with tapering regimens individualized to the patient...
June 2018: Primary Care
https://www.readbyqxmd.com/read/29745885/explorative-analyses-of-protein-biomarkers-in-patients-with-early-rheumatoid-arthritis-achieving-sustained-drug-free-remission-after-treatment-with-tocilizumab-or-methotrexate-based-strategies-from-transcriptomics-to-proteomics
#9
Xavier M Teitsma, Johannes W G Jacobs, Arno N Concepcion, Attila Pethö-Schramm, Michelle E A Borm, Jacob M van Laar, Johannes W J Bijlsma, Floris P J G Lafeber
OBJECTIVES: Previously, we identified networks of co-expressed genes related to achieving sustained drug-free remission (sDFR). The aim of the present exploratory analysis was to identify inflammatory proteins associated with achieving sDFR and their enriched biological pathways, and compare these pathways with those found in the previous transcriptomic analyses. METHODS: Serum samples were used from 60 patients who participated in the U-Act-Early trial and were treated-to-target with tocilizumab plus methotrexate, or tocilizumab or methotrexate; 37 achieved sDFR (≥3 months drug-free) and 23 did not (controls)...
May 8, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29745884/type-iv-collagen-metabolism-is-associated-with-disease-activity-radiographic-progression-and-response-to-tocilizumab-in-rheumatoid-arthritis
#10
Natasja Stæhr Gudmann, Peter Junker, Pernille Juhl, Christian Schneider Thudium, Anne Sofie Siebuhr, Inger Byrjalsen, Morten Asser Karsdal, Anne Christine Bay-Jensen
OBJECTIVES: The expanding spectrum of targeted therapies for rheumatoid arthritis (RA) implies a need for development of precision tools for disease assessment reflecting pathobiologic processes. Type IV collagen is an abundant protein of basement membranes, but is also present in the intercellular matrix of the synovial lining layer. We aimed to investigate the association of type IV collagen turnover with RA disease activity, response to IL-6 inhibition and radiographic progression...
May 8, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29742565/current-challenges-and-opportunities-in-the-management-of-antibody-mediated-rejection-in-lung-transplantation
#11
Amanda L Hulbert, Elizabeth N Pavlisko, Scott M Palmer
PURPOSE OF REVIEW: There is increasing recognition of the importance of antibody-mediated rejection (AMR) after lung transplantation. The development of donor-specific antibodies, a key feature of AMR, occurs in approximately 30% of lung transplant recipients and is associated with poor posttransplant outcomes. This review highlights recently developed AMR diagnostic criteria in lung transplantation, potential mechanisms that mediate the development of AMR, and discusses current and emerging treatment strategies for this significant, graft-limiting complication...
June 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29741120/late-onset-neutropenia-and-neurological-relapse-during-long-term-rituximab-therapy-in-myelin-oligodendrocyte-glycoprotein-antibody-spectrum-disorder
#12
Damien Biotti, Fleur Lerebours, Fabrice Bonneville, Jonathan Ciron, Michel Clanet, David Brassat
Late-onset neutropenia after rituximab therapy (LONART) is defined as a fall in the absolute neutrophil count below 500/mm3 at least 3 weeks after rituximab infusion, in the absence of any other explanation. LONART is rare during dysimmune conditions but can be life-threatening. We report on two patients with LONART and associated neurological relapse occurring in myelin oligodendrocyte glycoprotein (MOG)-antibody spectrum disorders. Rituximab was reintroduced in one patient, while the second patient was switched to tocilizumab...
May 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29730637/comparative-effectiveness-of-tocilizumab-versus-tnf-inhibitors-as-monotherapy-or-in-combination-with-conventional-synthetic-disease-modifying-antirheumatic-drugs-in-patients-with-rheumatoid-arthritis-after-the-use-of-at-least-one-biologic-disease-modifying
#13
Kim Lauper, Dan C Nordström, Karel Pavelka, Maria Victoria Hernández, Tore K Kvien, Eirik Klami Kristianslund, Maria Jose Santos, Žiga Rotar, Florenzo Iannone, Catalin Codreanu, Galina Lukina, Sara L Gale, Khaled Sarsour, Yves Luder, Delphine Sophie Courvoisier, Cem Gabay
OBJECTIVE: To compare the effectiveness of tocilizumab (TCZ) and tumour necrosis factor (TNF) inhibitors (TNFi) as monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) after the use of at least one biologic DMARD (bDMARD). METHODS: We included patients with RA having used at least one bDMARD from 10 European registries. We compared drug retention using Kaplan-Meier and Cox models and Clinical Disease Activity Index (CDAI) change over time with mixed-effects models for longitudinal data...
May 5, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29729868/treatment-of-takayasu-arteritis-with-the-il-6r-antibody-tocilizumab-vs-cyclophosphamide
#14
Xiufang Kong, Xiaojie Zhang, Peng Lv, Xiaomeng Cui, Lili Ma, Huiyong Chen, Hao Liu, Jiang Lin, Lindi Jiang
OBJECTIVE: To evaluate the treatment effects of the IL-6R antibody tocilizumab and cyclophosphamide (CTX) in patients with Takayasu arteritis (TA) and explore the mechanism by analyzing their effects on various cytokines. METHODS AND MATERIALS: This study included 9 TA patients treated with tocilizumab, 15 TA patients treated with CTX and 24 healthy controls. Treatment effects were evaluated based on: (1) Kerr score and Indian Takayasu Clinical Activity Score (ITAS2010), (2) improvement of previous lesions and occurrence of new vascular lesions on magnetic resonance angiography (MRA), (3) changes in various cytokine levels, (4) glucocorticoid sparing, and (5) adverse effects...
May 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29729444/non-glucocorticoid-drugs-for-the-treatment-of-takayasu-s-arteritis-a-systematic-review-and-meta-analysis
#15
REVIEW
Lillian Barra, Grace Yang, Christian Pagnoux
BACKGROUND: Takayasu's Arteritis (TAK) affects mostly young women and causes significant morbidity. Most patients are refractory to glucocorticoids (GC) or relapse when GC doses are reduced. The objective of this study is to summarize the literature pertaining to the effectiveness of non-GC drugs for the treatment of TAK. METHODS: MEDLINE and Embase were searched for English-language studies of TAK patients with a sample size >5. Studies were included if the effectiveness of non-GC drugs for the treatment of TAK was reported...
May 2, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29729100/immune-related-adverse-events-in-cancer-patients
#16
Daniel J Pallin, Christopher W Baugh, Michael A Postow, Jeffrey M Caterino, Timothy B Erickson, Gary H Lyman
The US Food and Drug Administration has approved immune checkpoint inhibitors and chimeric antigen receptor T cells (CAR-T cells) as immunotherapy strategies for cancer. These therapies cause a wide variety of adverse events, which mimic other disease states, and may emerge months after completion of treatment. This is important because ascertaining a past medical history of cancer treatment within the past year becomes necessary for many presentations. This narrative review summarizes the biology, pathophysiology and adverse events associated with checkpoint inhibitors and CAR-T cells, and provides a rational approach to management...
May 5, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29720225/the-role-of-exercise-combined-with-tocilizumab-in-visceral-and-epicardial-adipose-tissue-and-gastric-emptying-rate-in-abdominally-obese-participants-protocol-for-a-randomised-controlled-trial
#17
Regitse Højgaard Christensen, Anne-Sophie Wedell-Neergaard, Louise Lang Lehrskov, Grit Elster Legård, Emma Berndt Dorph, Stine Nymand, Maria Korf Ball, Morten Zacho, Robin Christensen, Helga Ellingsgaard, Jaya Birgitte Rosenmeier, Rikke Krogh-Madsen, Bente Klarlund Pedersen, Kristian Karstoft
BACKGROUND: Exercise reduces the amount of visceral adipose tissue (VAT) and the risk of cardiometabolic diseases. The underlying mechanisms responsible for these exercise-induced adaptations are unclear, but they may involve lipolytic actions of interleukin-6 (IL-6). Contracting skeletal muscles secrete IL-6, leading to increased circulating IL-6 levels in response to exercise. The aim of this study is to investigate whether IL-6 is involved in mediating the effects of exercise on visceral and epicardial adipose tissue volume and glycaemic control...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29701172/tocilizumab-histologically-improved-aa-renal-amyloidosis-in-a-patient-with-multicentric-castleman-disease-a-case-report
#18
Yumi Yamada, Toshinori Ueno, Taisuke Irifuku, Ayumu Nakashima, Shigehiro Doi, Tatsuo Ichinohe, Takao Masaki
Multicentric Castleman disease (MCD) is a rare systemic lymphoproliferative disorder and is infrequently associated with renal complications that include amyloid A (AA) amyloidosis. Although it has been reported that patients with MCD and amyloidosis usually have a poor prognosis, recently, tocilizumab, a humanized anti-interleukin-6 receptor antibody, has emerged as an effective and specific treatment for AA amyloidosis secondary to chronic inflammatory disorders. Here we report a case of an MCD patient with secondary AA renal amyloidosis who was successfully treated with tocilizumab...
April 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29694426/effects-of-tumor-necrosis-factor-inhibitors-and-tocilizumab-on-the-glycosylated-hemoglobin-levels-in-patients-with-rheumatoid-arthritis-an-observational-study
#19
Yukimi Otsuka, Chikako Kiyohara, Yusuke Kashiwado, Takuya Sawabe, Shuji Nagano, Yasutaka Kimoto, Masahiro Ayano, Hiroki Mitoma, Mitsuteru Akahoshi, Yojiro Arinobu, Hiroaki Niiro, Koichi Akashi, Takahiko Horiuchi
Rheumatoid arthritis (RA) and diabetes mellitus (DM) are associated with inflammation. We tried to investigate the influence of tumor necrosis factor inhibitors (TNFi) and tocilizumab (TCZ) on the glucose metabolism of RA patients. RA patients in whom treatment with TNFi or TCZ was initiated from 2008 to 2015 were studied based on their medical records. We analyzed patients whose glycosylated hemoglobin (HbA1c) levels were measured both before and 3 months after the initiation of these biologic agents. The association between HbA1c reduction and the treatment was evaluated...
2018: PloS One
https://www.readbyqxmd.com/read/29678346/efficacy-of-tocilizumab-in-takayasu-arteritis-multicenter-retrospective-study-of-46-patients
#20
Arsene Mekinian, Mathieu Resche-Rigon, Cloé Comarmond, Alessandra Soriano, Joel Constans, Laurent Alric, Patrick Jego, Florian Busato, Matthieu Cabon, Robin Dhote, Lazaro Estibaliz, Isabelle Kone Pault, Cédric Landron, Christian Lavigne, Bertrand Lioger, Martin Michaud, Marc Ruivard, Karim Sacre, Jacques Eric Gottenberg, Francis Gaches, Tiphaine Goulenok, Carlo Salvarani, Patrice Cacoub, Olivier Fain, David Saadoun
OBJECTIVES: To assess the efficacy of tocilizumab in patients with Takayasu arteritis (TA). METHODS: We conducted a retrospective multicenter study in 46 TA patients treated with tocilizumab. We analyzed factors associated with response to tocilizumab (assessed using NIH score). RESULTS: Forty-six patients with TA were included, with a median age of 43 years [29-54], and 35 (76%) females. We observed a decrease in the median NIH scale (from 3 [2-3] at baseline to 0 [0-1] and 0 at 3 and 6 months, respectively; p < 0...
April 17, 2018: Journal of Autoimmunity
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