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Discontinuation of anti-TNF

Park Ju Ho, Jang Jun Sung, Kim Ki Cheon, Hong Jin Tae
BACKGROUND: Centella asiatica phytosome (CA phytosome) has potent antioxidant and anti-inflammatory properties. However, its anti-dermatitic effect has not yet been reported. PURPOSE: We investigated the effects of CA phytosome on inflammatory reponses by macrophages in an atopic dermatitis (AD) mouse model. STUDY DESIGN: The effects of CA phytosome on atopic dermatitis were examined by using phthalic anhydride (PA)-induced AD mouse model and RAW 264...
April 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
A Ramadan, Nehal Afifi, Nemat Z Yassin, Rehab F Abdel-Rahman, Sahar S Abd El-Rahman, Hany M Fayed
Liver fibrosis is a major health issue leading to high morbidity and mortality. The potential anti-fibrotic activity and the effect of mesalazine on osteopontin (OPN), an extra cellular matrix (ECM) component were evaluated in TAA-induced liver fibrosis in rats. For this purpose, forty-two adult male Wistar rats were divided into six groups. All animals, except the normal control, were intraperitoneally injected with TAA (200 mg/kg) twice per week for 6 weeks. In the hepato-protective study, animals were administered mesalazine (50 and 100 mg/kg, orally) for 4 weeks before induction of liver fibrosis then concomitantly with TAA injection...
May 5, 2018: Chemico-biological Interactions
Clémence Legué, Charlène Brochard, Grégoire Bessi, Timothée Wallenhorst, Marie Dewitte, Laurent Siproudhis, Guillaume Bouguen
Background: Discontinuation of antitumour necrosis factor (TNF)α therapy with perianal fistulising Crohn's disease remains controversial due to the risk of severe relapse without any clear evidence. Aim: The aim of this study was to assess the rate and type of perianal and luminal relapses following anti-TNFα discontinuation. Methods: All patients treated with anti-TNFα for perianal fistulising Crohn's disease with subsequent discontinuation of therapy were retrospectively reviewed from a prospective database (1998-2016)...
May 4, 2018: Inflammatory Bowel Diseases
Emily C Pfeifer, David R Saxon, Robert W Janson
Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis and inflammation involving the axial skeleton and/or peripheral joints. It is more likely to be associated with metabolic syndrome and diabetes when compared with other inflammatory arthritides. Tumor necrosis factor-α (TNF-α) is one of several cytokines often elevated in rheumatologic disorders including PsA and has also been found to be elevated in patients with obesity, metabolic syndrome, diabetes, and/or atherosclerotic disease...
July 2017: Journal of Investigative Medicine High Impact Case Reports
Sadeea Q Abbasi, Gil Y Melmed
No abstract text is available yet for this article.
April 26, 2018: Journal of Crohn's & Colitis
Amit Chopra, Amit Nautiyal, Alexander Kalkanis, Marc A Judson
A drug-induced sarcoidosis-like reaction (DISR) is a systemic granulomatous reaction that is indistinguishable from sarcoidosis and occurs in temporal relationship with initiation of an offending drug. DISRs typically improve or resolve after the withdrawal of offending drug. Four common categories of drugs that have been associated with the development of a DISR are immune checkpoint inhibitors (ICIs), highly active anti-retroviral therapy (HAART), interferons (IFNs) and tumor necrosis factor alpha antagonists (TNF-alpha antagonists)...
April 23, 2018: Chest
Claudia Fabiani, Antonio Vitale, Donato Rigante, Giacomo Emmi, Giuseppe Lopalco, Jurgen Sota, Lorenzo Vannozzi, Gerardo di Scala, Silvana Guerriero, Ida Orlando, Rossella Franceschini, Marco Capozzoli, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Luca Cantarini
To identify clinical variables capable of predicting long-term treatment duration of TNF-α inhibition in patients with Behçet's disease (BD)-related uveitis. Demographic, clinical, and therapeutic data were retrospectively collected from BD patients treated with the tumor necrosis factor (TNF)-α blockers infliximab and adalimumab. Patients still continuing TNF-α inhibitors at 48-month follow-up visits were classified as long-term responders and were statistically compared to patients discontinuing treatment before the 48-month visit...
April 18, 2018: Clinical Rheumatology
Özgür M Koc, Roel J W van Kampen, Adriaan A van Bodegraven
Background: The prevalence of inflammatory bowel disease (IBD) is increasing and, consequently, more IBD patients will develop cancer with need for cancer-associated chemotherapy. Physicians are therefore confronted with whether they should continue, stop, or restart IBD medication in relation with chemotherapy. The current strategy in our hospital is to discontinue immunomodulating IBD medication, comprising corticosteroids, anti-tumour necrosis factor (anti-TNF), and other immunosuppressives, before starting chemotherapy...
April 13, 2018: Inflammatory Bowel Diseases
Lydia C T Buer, Marte L Høivik, David J Warren, Asle W Medhus, Bjørn A Moum
Background: Anti-tumor necrosis factor α (anti-TNF-α) is important in the treatment of inflammatory bowel disease, but some patients experience only a partial response. In these patients, a combination of anti-TNF-α and vedolizumab (VDZ) may act as a bridge until the full VDZ effect occurs. At present, clinical data on combination treatment with anti-TNF-α and VDZ are not available. The aim of this case series was to evaluate the safety and clinical response of combination therapy with anti-TNF-α and VDZ in clinical practice...
April 12, 2018: Inflammatory Bowel Diseases
Przemysław Holko, Paweł Kawalec, Andrzej Pilc
OBJECTIVE: The aim was to evaluate the cost-effectiveness of Crohn's disease (CD) treatment with vedolizumab and ustekinumab after failure of therapy with tumor necrosis factor-α antagonists (anti-TNFs). METHODS: The Markov model incorporated the lifetime horizon, synthesis-based estimates of biologics' efficacy in relation to anti-TNF exposure, and administration of biologics reflecting clinical practice (e.g., sequence of biologics, retreatment, 12-month treatment)...
April 17, 2018: PharmacoEconomics
Lieke Tweehuysen, Nathan den Broeder, Noortje van Herwaarden, Leo A B Joosten, Peter L van Lent, Thomas Vogl, Frank H J van den Hoogen, Rogier M Thurlings, Alfons A den Broeder
Objectives: Calprotectin (S100A8/A9) has been correlated with disease activity in rheumatoid arthritis (RA). The aim of this study was to investigate the predictive value of serum calprotectin for clinical response after starting and tapering anti-tumour necrosis factor treatment in RA. Methods: Serum samples and clinical outcomes were derived from two longitudinal RA studies.At baseline (starting or tapering of adalimumab or etanercept), calprotectin levels were determined by ELISA...
2018: RMD Open
Megan E B Clowse, Angela E Scheuerle, Christina Chambers, Anita Afzali, Alexa B Kimball, John J Cush, Maureen Cooney, Laura Shaughnessy, Mark Vanderkelen, Frauke Förger
BACKGROUND: Anti-tumor necrosis factor medications (anti-TNFs) are effective in controlling chronic inflammatory diseases, but information about their use and safety in pregnancy is limited. Consequently, anti-TNFs are often discontinued early in gestation. Certolizumab pegol (CZP), a PEGylated, Fc-free anti-TNF approved for treatment of rheumatic diseases and/or Crohn's disease, has minimal to no active placental transfer. This project provides information on pregnancy outcomes in women receiving CZP, especially those with early pregnancy exposure...
April 5, 2018: Arthritis & Rheumatology
Carl Eriksson, Sara Rundquist, Yang Cao, Scott Montgomery, Jonas Halfvarson
OBJECTIVE: Thiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation. DESIGN: Patients diagnosed with UC within the Örebro University Hospital catchment area, during 1963-2010, who initiated thiopurines (n=253) were included...
April 4, 2018: Gut
Daniel J Lovell, Anne L Johnson, Bin Huang, Beth S Gottlieb, Paula W Morris, Yukiko Kimura, Karen Onel, Suzanne C Li, Alexei A Grom, Janalee Taylor, Hermine I Brunner, Jennifer L Huggins, James J Nocton, Kathleen A Haines, Barbara S Edelheit, Michael Shishov, Lawrence K Jung, Calvin B Williams, Melissa S Tesher, Denise M Costanzo, Lawrence S Zemel, Jason A Dare, Murray H Passo, Kaleo C Ede, Judyann C Olson, Elaine A Cassidy, Thomas A Griffin, Linda Wagner-Weiner, Jennifer E Weiss, Larry B Vogler, Kelly A Rouster-Stevens, Timothy Beukelman, Randy Q Cron, Daniel Kietz, Kenneth Schikler, Jay Mehta, Tracy V Ting, James W Verbsky, B Anne Eberhard, Steven Spalding, Chen Chen, Edward H Giannini
OBJECTIVE: Determine the frequency, time-to-flare, and predictors of disease flare upon withdrawal of anti-tumor necrosis factor (TNF) therapy in children with polyarticular forms of juvenile idiopathic arthritis (PF-JIA) who demonstrated ≥ 6 continuous months of clinical inactive disease (CID). METHODS: In 16 centers 137 patients with PF-JIA in CID on anti-TNF therapy (42% of whom were also on methotrexate [MTX]) were prospectively followed. If CID was maintained for the initial 6 months on study anti-TNF was stopped and patients assessed for flare at 1, 2, 3, 4, 6, and 8 months...
March 31, 2018: Arthritis & Rheumatology
Mark R Serpico, Ross Maltz, Wallace Crandall, Josh Bricker, Jennifer L Dotson, Sandra C Kim, Brendan Boyle
OBJECTIVES: Thiopurines are commonly used in the maintenance of remission for children with inflammatory bowel diseases (IBD). Variation in drug metabolism may impact hepatotoxicity or therapeutic effect. We aimed to describe our center's experience with thiopurine optimization through the use of reduced thiopurine dosing in combination with allopurinol upon hepatotoxicity, drug metabolite levels and clinical outcomes in children with IBD. METHODS: Patients aged 2-21 years with IBD treated with the combination of thiopurines/allopurinol between 2008-2015 were retrospectively reviewed...
March 29, 2018: Journal of Pediatric Gastroenterology and Nutrition
Ma Magdalena Alcover, Vicenç Rocamora, Ma Carmen Guillén, Diana Berenguer, Marta Cuadrado, Cristina Riera, Roser Fisa
This case report highlights the risk of severe cutaneous leishmaniasis (CL) by Leishmania infantum in patients undergoing immunosuppressant therapy who either live in an endemic area or are visiting in the transmission season. The case patient, resident in Majorca (Balearic Islands), presented 12 disseminated erythematous skin lesions, 1-6 cm in diameter, located on the scalp, cheek, umbilical region, and lower extremities 8 years after undergoing anti-tumor necrosis factor (TNF) therapy. Parasite presence in peripheral blood and high levels of specific antibodies were also observed, indicating a possible risk of CL shifting toward a visceral infection...
March 26, 2018: American Journal of Tropical Medicine and Hygiene
H Peeters, E Louis, F Baert, O Dewit, J C Coche, M Ferrante, G Lambrecht, A Colard, A Van Gossum, P Bossuyt, T Moreels, B Vander Cruyssen, A Gils, M De Vos
BACKGROUND AND STUDY AIMS: Anti-TNF monoclonal antibodies are a cornerstone in the treatment of Crohn's disease. Prospective data on switching from the subcutaneous and human adalimumab (ADM) to the intravenous and chimeric infliximab (IFX) are scarce. PATIENTS AND METHODS: In this prospective, observational, multicentre cohort study we included 21 patients with loss of response to ADM despite at least 4 consecutive weekly injections. Clinical response (CDAI drop≥70 points) and remission (CDAI≤150) were assessed after switching from ADM to IFX after 10 weeks, 6 and 12 months...
January 2018: Acta Gastro-enterologica Belgica
Konstantinos H Katsanos, Konstantinos Papamichael, Joseph D Feuerstein, Dimitrios K Christodoulou, Adam S Cheifetz
The pharmacological management of inflammatory bowel disease (IBD) over the last two decades has transitioned from reliance on aminosalycilates, corticosteroids and immunomodulators to earlier treatment with anti-tumor necrosis factor (anti-TNF) therapy. Nevertheless, 20-30% of patients discontinue anti-TNF therapy for primary non-response and another 30-40% for losing response within one year of treatment. These undesirable therapeutic outcomes can be attributed to pharmacokinetic (anti-drug antibodies and/or low drug concentrations) or pharmacodynamic issues characterized by a non-TNF driven inflammation...
March 12, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Iris M Otani, Amy S Levin, Aleena Banerji
PURPOSE OF REVIEW: The goal of this paper is to review the major adverse cutaneous reactions that have been reported to the most commonly used biologics. RECENT FINDINGS: Anti-TNF agents and immune checkpoint inhibitors have significant, immune-mediated cutaneous manifestations that can necessitate discontinuation. Anti-TNF agents, IL-6 inhibitors, and IL-12/23 inhibitors can paradoxically cause psoriasis flares or unmask previously undiagnosed psoriasis. IL-17 inhibitors are unique in increasing risk for Candida infections...
February 21, 2018: Current Allergy and Asthma Reports
Siddharth Singh, John George, Brigid S Boland, Niels Vande Casteele, William J Sandborn
Background and Aims: We sought to analyze whether response to second-line biologic varies depending on reason for discontinuation of primary anti-TNF agent (primary non-response [PNR], secondary loss of response [LOR] after initial response, or intolerance), through a systematic review and meta-analysis. Methods: Through a systematic search through May 31, 2017, we identified 8 randomized controlled trials (RCTs) of biologics in patients with IBD with prior exposure to anti-TNF agents, that stratified response to second-line therapy by reason for discontinuing primary anti-TNF therapy (PNR vs...
January 23, 2018: Journal of Crohn's & Colitis
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