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https://www.readbyqxmd.com/read/28630629/the-cedar-study-a-longitudinal-study-of-the-clinical-effects-of-conventional-dmards-and-biologic-dmards-in-australian-rheumatology-practice
#1
Lynden Roberts, Kathleen Tymms, Julien de Jager, Geoffrey Littlejohn, Hedley Griffiths, Dave Nicholls, Paul Bird, Jennifer Young, Julie Hill, Jane Zochling
OBJECTIVES: To observe the choices of conventional disease modifying antirheumatic drugs (cDMARDs) and biologic DMARDs (bDMARDs) in the management of rheumatoid arthritis (RA) in Australian routine clinical practice, to assess treatment survival and determine the effect of cDMARDs/bDMARDs on disease activity. METHODS: Routinely collected, deidentified clinical data was sourced from 20 Australian rheumatology practices. RA patients aged ≥18 years, who had received cDMARDs/bDMARDs and a recorded subsequent visit, were included...
2017: International Journal of Rheumatology
https://www.readbyqxmd.com/read/28629694/interleukin-6-participation-in-pathology-of-ocular-diseases
#2
REVIEW
Forouhe Zahir-Jouzdani, Fatemeh Atyabi, Nazanin Mojtabavi
Interleukin-6 (IL-6) is a multifunctional cytokine that affects a variety of cells in the body such as osteoclasts, hepatocytes, endothelial cells, epithelial cells, white and red blood cells and etc. Elevated levels of IL-6 have been detected in many ocular diseases. Studies show that IL-6 has a major role in the pathology of glaucoma, CRVO, macular edema, ocular neovascularization, posterior capsule opacity formation, keratitis, dry eye disease, allergic eye disease, ocular autoimmune disease, corneal chemical burn, ocular inflammation and so on...
June 10, 2017: Pathophysiology: the Official Journal of the International Society for Pathophysiology
https://www.readbyqxmd.com/read/28626189/successful-switch-to-golimumab-for-eosinophilia-and-skin-symptoms-related-to-multiple-biologics-in-a-patient-with-rheumatoid-arthritis
#3
Naoto Azuma, Kiyoshi Matsui, Naoaki Hashimoto, Takahiro Yoshikawa, Hajime Sano
Biologics used in the treatment of rheumatoid arthritis (RA) rarely cause eosinophilia. We herein report a patient with RA being treated with infliximab, adalimumab, and tocilizumab who developed eosinophilia with skin symptoms. Interestingly, the marked eosinophilia and skin symptoms did not reappear after the patient's medication was switched to golimumab. In this case, the presence of biologics-specific antibodies suggested that immunogenicity caused the eosinophilia. Therefore, switching to a biologic with a lower immunogenicity was effective...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28622454/treatment-of-rheumatoid-arthritis-with-anti-tumor-necrosis-factor-or-tocilizumab-therapy-as-first-biologic-in-a-global-comparative-observational-study
#4
Ernest H Choy, Corrado Bernasconi, Maher Aassi, Jose Fernando Molina, Oscar Massimiliano Epis
OBJECTIVE: Compare clinical effectiveness between tocilizumab and tumor necrosis factor inhibitors (TNFi) in patients with rheumatoid arthritis and inadequate response to conventional synthetic disease-modifying antirheumatic drugs initiating biologic therapy. METHODS: Patients prescribed tocilizumab (intravenous) or TNFi were prospectively observed in routine clinical practice for 52 weeks across 158 sites in 26 countries. The primary observation was change from baseline in Disease Activity Score based on 28 joints-erythrocyte sedimentation rate (DAS28-ESR) at week 24 using analysis of covariance for between-group comparison...
June 16, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28622048/a-randomized-double-blind-parallel-group-phase-iii-study-of-shortening-the-dosing-interval-of-subcutaneous-tocilizumab-monotherapy-in-patients-with-rheumatoid-arthritis-and-an-inadequate-response-to-subcutaneous-tocilizumab-every-other-week-results-of-the-12
#5
Atsushi Ogata, Yoshiya Tanaka, Tomonori Ishii, Motohide Kaneko, Hiroko Miwa, Shino Ohsawa
OBJECTIVE: To determine the efficacy and safety of subcutaneous tocilizumab (TCZ-SC) monotherapy every week (qw) versus every other week (q2w) in patients with rheumatoid arthritis who had an inadequate response to TCZ-SC q2w. METHODS: Adult patients in Japan with inadequate response to TCZ-SC q2w were randomized to either TCZ-SC 162 mg qw monotherapy or TCZ-SC 162 mg q2w monotherapy for 12 weeks (double-blind). The primary endpoint was the change from baseline in adjusted Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) at week 12...
June 16, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28615731/the-role-of-il-6-in-host-defence-against-infections-immunobiology-and-clinical-implications
#6
REVIEW
Stefan Rose-John, Kevin Winthrop, Leonard Calabrese
IL-6 is a pleiotropic cytokine with broad-ranging effects within the integrated immune response. One of the roles of IL-6 is to support immunocompetence, defined as the ability of a host to respond to infections. Understanding the precise role of this cytokine in immunocompetence requires a critical appraisal of data derived from both preclinical and clinical studies. Primary immunodeficiency diseases involving IL-6 or its signalling pathways reveal that IL-6 is critical in the defence against numerous types of pathogens...
July 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28610606/biologic-therapies-for-refractory-juvenile-dermatomyositis-five-years-of-experience-of-the-childhood-arthritis-and-rheumatology-research-alliance-in-north-america
#7
C H Spencer, K Rouster-Stevens, H Gewanter, G Syverson, R Modica, K Schmidt, H Emery, C Wallace, S Grevich, K Nanda, Y D Zhao, S Shenoi, S Tarvin, S Hong, C Lindsley, J E Weiss, M Passo, K Ede, A Brown, K Ardalan, W Bernal, M L Stoll, B Lang, R Carrasco, C Agaiar, L Feller, H Bukulmez, R Vehe, H Kim, H Schmeling, D Gerstbacher, M Hoeltzel, B Eberhard, R Sundel, S Kim, A M Huber, A Patwardhan
BACKGROUND: The prognosis of children with juvenile dermatomyositis (JDM) has improved remarkably since the 1960's with the use of corticosteroid and immunosuppressive therapy. Yet there remain a minority of children who have refractory disease. Since 2003 the sporadic use of biologics (genetically-engineered proteins that usually are derived from human genes) for inflammatory myositis has been reported. In 2011-2016 we investigated our collective experience of biologics in JDM through the Childhood Arthritis and Rheumatology Research Alliance (CARRA)...
June 13, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28598787/severe-adverse-drug-reactions-to-biological-disease-modifying-anti-rheumatic-drugs-in-elderly-patients-with-rheumatoid-arthritis-in-clinical-practice
#8
Leticia Leon, Alejandro Gomez, Cristina Vadillo, Esperanza Pato, Luis Rodriguez-Rodriguez, Juan Angel Jover, Lydia Abasolo
OBJECTIVES: Biological DMARDs are widely used in the treatment of rheumatoid arthritis (RA) but their relationship with adverse drug reaction (ADR) is important. RA is now known to increase in incidence and prevalence with age. Our objective was to assess the incidence of severe ADR in the long term, compare safety between the different bDMARDs and identify other possible risk factors for severe ADR in elderly RA patients. METHODS: A 14-year retrospective longitudinal study was performed...
June 6, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28597609/transaminase-levels-and-hepatic-events-during-tocilizumab-treatment-pooled-analysis-of-long-term-clinical-trial-safety-data-in-rheumatoid-arthritis
#9
Mark C Genovese, Joel M Kremer, Ronald F van Vollenhoven, Rieke Alten, Juan Jose Scali, Ariella Kelman, Sophie Dimonaco, Laura Brockwell
OBJECTIVE: Investigate liver enzyme abnormalities and hepatic adverse events (AEs) during long-term tocilizumab treatment for rheumatoid arthritis (RA) in clinical trials. METHODS: Data were pooled from patients who received intravenous tocilizumab (4, 8, or 10 mg/kg ± disease-modifying antirheumatic drugs [DMARDs]) in phase 3 or 4 clinical trials, long-term extensions, and a pharmacology study. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured routinely in these trials...
June 8, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28594905/comparative-risk-of-hospitalized-infection-between-biological-agents-in-rheumatoid-arthritis-patients-a-multicenter-retrospective-cohort-study-in-japan
#10
Shunsuke Mori, Tamami Yoshitama, Toshihiko Hidaka, Fumikazu Sakai, Mizue Hasegawa, Yayoi Hashiba, Eiichi Suematsu, Hiroshi Tatsukawa, Akinari Mizokami, Shigeru Yoshizawa, Naoyuki Hirakata, Yukitaka Ueki
OBJECTIVE: Knowing the risk of hospitalized infection associated with individual biological agents is an important factor in selecting the best treatment option for patients with rheumatoid arthritis (RA). This study examined the comparative risk of hospitalized infection between biological agents in a routine care setting. METHODS: We used data for all RA patients who had first begun biological therapy at rheumatology divisions of participating community hospitals in Japan between January 2009 and December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28589389/-safety-and-efficacy-of-off-label-use-of-biologic-therapies-in-patients-with-inflammatory-rheumatic-diseases-refractory-to-standard-of-care-therapy-data-from-a%C3%A2-nationwide-german-registry-graid2
#11
F Proft, H Schulze-Koops, M Grunke, E Schrezenmeier, F Halleck, J Henes, L Unger, E Schmidt, C Fiehn, A Jacobi, C Iking-Konert, C Kneitz, R E Schmidt, B Bannert, R E Voll, R Fischer-Betz, I Kötter, H P Tony, J Holle, M Aringer, A Erler, F Behrens, G R Burmester, T Dörner
BACKGROUND: The German Registry of Autoimmune Diseases 2 (GRAID2) is a retrospective, non-interventional, multicenter registry study collecting data from patients with inflammatory, mainly rheumatic diseases refractory to standard of care therapy and treated with an off-label biologic therapy. The retrospective documentation comprised case history, diagnosis, course of disease (including safety and global efficacy). The objective was to evaluate the global clinical outcome and safety of off-label biologic therapy in clinical practice...
June 6, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28583784/periodic-fever-from-still-s-disease-to-muckle-wells-syndrome
#12
Marta Nataya Solís Marquínez, Edilia García Fernández, Joaquín Morís de la Tassa
Muckle-Wells syndrome is a systemic autoinflammatory disease included in the group of hereditary periodic febrile syndromes. We report the case of a patient with this rare disease to call the attention to the singularity of this condition, its low incidence, its atypical presentation and the subsequent delay in the diagnosis, which is reached when late and devastating consequences have taken place. In this case, the first-line therapy, anti-interleukin 1 (IL-1), failed to control the disease. Nevertheless, the IL-6 inhibitor, tocilizumab, proved effective, achieving the total remission of nephrotic syndrome associated with AA secondary amyloidosis, changing the bleak prognosis of this disease...
June 2, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28579757/profile-of-sarilumab-and-its-potential-in-the-treatment-of-rheumatoid-arthritis
#13
REVIEW
Maria Gabriella Raimondo, Martina Biggioggero, Chiara Crotti, Andrea Becciolini, Ennio Giulio Favalli
In recent years the use of biotechnological agents has drastically revolutionized the therapeutic approach and the progression of rheumatoid arthritis (RA). In particular, interleukin-6 (IL-6) has been demonstrated as a pivotal cytokine in the pathogenesis of the disease by contributing to both the innate and the adaptive immune system perturbation, and to the production of acute-phase proteins involved in the systemic expression of the disorder. The first marketed IL-6 blocker was tocilizumab, a humanized anti-IL-6 receptor (anti-IL-6R) monoclonal antibody...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28575416/toxic-drug-induced-liver-failure-during-therapy-of-rheumatoid-arthritis-with-tocilizumab-subcutaneously-a-case-report
#14
Friedrich Anger, Armin Wiegering, Johanna Wagner, Johan Lock, Johannes Baur, Lukas Haug, Marc Schmalzing, Andreas Geier, Stefan Löb, Ingo Klein
No abstract text is available yet for this article.
June 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28572233/lesson-of-the-month-1-septic-arthritis-with-normal-acute-phase-reactants-and-white-cell-count-in-a-patient-receiving-tocilizumab
#15
Richard Conway, Carl Orr, Geraldine M McCarthy
Septic arthritis represents 8-27% of cases of monoarthritis presenting to the emergency department. Tocilizumab is an interleukin-6 blocking monoclonal antibody with the mechanistic potential to interfere with the body's normal inflammatory response to an infectious insult. We present a case of septic arthritis with a normal white cell count, C-reactive protein, erythrocyte sedimentation rate and fibrinogen in a patient treated with tocilizumab.
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28570568/the-risk-of-tuberculosis-disease-in-rheumatoid-arthritis-patients-on-biologics-and-targeted-therapy-a-15-year-real-world-experience-in-taiwan
#16
Chong Hong Lim, Hsin-Hua Chen, Yi-Hsing Chen, Der-Yuan Chen, Wen-Nan Huang, Jaw-Ji Tsai, Tsu-Yi Hsieh, Chia-Wei Hsieh, Wei-Ting Hung, Ching-Tsai Lin, Kuo-Lung Lai, Kuo-Tung Tang, Chih-Wei Tseng, Yi-Ming Chen
The objective of this study is to determine the risk of tuberculosis (TB) disease in biologics users among rheumatoid arthritis (RA) patients in Taiwan from 2000 to 2015. This retrospective cohort study enrolled adult RA patients initiated on first biologics at Taichung Veterans General Hospital. TB risks were determined as hazard ratio (HR) with 95% confidence interval (CI) using cox regression. A total of 951 patients were recruited; etanercept (n = 443), adalimumab (n = 332), abatacept (n = 74), golimumab (n = 60), tocilizumab (n = 31) and tofacitinib (n = 11)...
2017: PloS One
https://www.readbyqxmd.com/read/28558744/tocilizumab-in-the-treatment-of-twelve-cases-with-aa-amyloidosis-secondary-to-familial-mediterranean-fever
#17
Serdal Ugurlu, Aysa Hacioglu, Yasaman Adibnia, Vedat Hamuryudan, Huri Ozdogan
BACKGROUND: There is no established treatment of AA amyloidosis, a long-term complication of various chronic inflammatory diseases associated with increased mortality, such as familial Mediterranian fever (FMF). Recently there are few reports pointing out that tocilizumab(TCZ), an anti IL-6 agent may be effective in AA amyloidosis resistant to conventional treatments. We report our data on the effect of TCZ in patients with FMF complicated with AA amyloidosis. METHODS: FMF patients with histologically proven AA amyloidosis, treated with TCZ (8 mg/kg per month) were followed monthly and the changes in creatinine, creatinine clearance, the amount of 24-hour urinary protein, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were noted throughout the treatment period...
May 30, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28550592/certolizumab-pegol-for-treating-rheumatoid-arthritis-following-inadequate-response-to-a-tnf-%C3%AE-inhibitor-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#18
REVIEW
Iñigo Bermejo, Matt Stevenson, Rachel Archer, John W Stevens, Edward Goka, Mark Clowes, David L Scott, Adam Young
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (UCB Pharma) of certolizumab pegol (CZP; Cimzia(®)) to submit evidence of its clinical and cost effectiveness for the treatment of rheumatoid arthritis (RA) following inadequate response to a tumour necrosis factor-α inhibitor (TNFi). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
May 26, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28545554/whipple-s-disease-mimicking-rheumatoid-arthritis-can-cause-misdiagnosis-and-treatment-failure
#19
Cornelia Glaser, Siegbert Rieg, Thorsten Wiech, Christine Scholz, Dominique Endres, Oliver Stich, Peter Hasselblatt, Walter Geißdörfer, Christian Bogdan, Annerose Serr, Georg Häcker, Reinhard E Voll, Jens Thiel, Nils Venhoff
BACKGROUND: Whipple's disease, a rare chronic infectious disorder caused by Tropheryma whipplei, may present with predominant joint manifestations mimicking rheumatoid arthritis (RA). METHODS: A retrospective single-center cohort study of seven patients was performed. Clinical symptoms were assessed by review of medical charts and Whipple's disease was diagnosed by periodic-acid-Schiff-stain and/or Tropheryma whipplei-specific polymerase-chain-reaction. RESULTS: Median age at disease onset was 54 years, six patients were male...
May 25, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28544595/severe-cytokine-release-syndrome-in-a-patient-receiving-pd-1-directed-therapy
#20
Seth J Rotz, Daniel Leino, Sara Szabo, Jennifer L Mangino, Brian K Turpin, Joseph G Pressey
Cytokine release syndrome (CRS) is a phenomenon of immune hyperactivation described in the setting of cellular and bispecific T-cell engaging immunotherapy. Checkpoint blockade using anti-programmed cell death 1 (anti-PD-1) inhibitors is an approach to antitumor immune system stimulation. A 29-year-old female with alveolar soft part sarcoma developed severe CRS after treatment with anti-PD-1 therapy. CRS was characterized by high fevers, encephalopathy, hypotension, hypoxia, hepatic dysfunction, and evidence of coagulopathy, and resolved after infusion of the interleukin-6 inhibitor tocilizumab and corticosteroids...
May 24, 2017: Pediatric Blood & Cancer
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